Provider Demographics
NPI:1487641239
Name:GREENBERG, ANTHONY (MD)
Entity Type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:
Last Name:GREENBERG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:576 STATE ROUTE 94
Mailing Address - Street 2:SUITE # 3
Mailing Address - City:COLUMBIA
Mailing Address - State:NJ
Mailing Address - Zip Code:07832-2523
Mailing Address - Country:US
Mailing Address - Phone:908-496-4600
Mailing Address - Fax:908-496-9414
Practice Address - Street 1:576 STATE ROUTE 94
Practice Address - Street 2:SUITE # 3
Practice Address - City:COLUMBIA
Practice Address - State:NJ
Practice Address - Zip Code:07832-2523
Practice Address - Country:US
Practice Address - Phone:908-496-4600
Practice Address - Fax:908-496-9414
Is Sole Proprietor?:No
Enumeration Date:2005-10-05
Last Update Date:2021-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA05555500207Q00000X, 208VP0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJF21884Medicare UPIN
713380Medicare ID - Type Unspecified