Provider Demographics
NPI:1497896013
Name:GREENBERG CHIROPRACTIC LLC
Entity Type:Organization
Organization Name:GREENBERG CHIROPRACTIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JONATHAN
Authorized Official - Middle Name:
Authorized Official - Last Name:GREENBERG
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:609-823-9300
Mailing Address - Street 1:9414 VENTNOR AVE # A
Mailing Address - Street 2:
Mailing Address - City:MARGATE CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:08402-2317
Mailing Address - Country:US
Mailing Address - Phone:609-823-9300
Mailing Address - Fax:609-823-9505
Practice Address - Street 1:9414 VENTNOR AVE # A
Practice Address - Street 2:
Practice Address - City:MARGATE CITY
Practice Address - State:NJ
Practice Address - Zip Code:08402-2317
Practice Address - Country:US
Practice Address - Phone:609-823-9300
Practice Address - Fax:609-823-9505
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Not Answered111NS0005XChiropractic ProvidersChiropractorSports PhysicianGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
U88292Medicare UPIN
NJ053674Medicare ID - Type Unspecified