Provider Demographics
NPI:1508834359
Name:GREENE, ARTHUR J (MD)
Entity Type:Individual
Prefix:MR
First Name:ARTHUR
Middle Name:J
Last Name:GREENE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1101 KINGS HWY N
Mailing Address - Street 2:SUITE 104
Mailing Address - City:CHERRY HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08034-1912
Mailing Address - Country:US
Mailing Address - Phone:856-482-2900
Mailing Address - Fax:856-482-5127
Practice Address - Street 1:1000 S LENOLA RD
Practice Address - Street 2:STE 105
Practice Address - City:MAPLE SHADE
Practice Address - State:NJ
Practice Address - Zip Code:08052-1630
Practice Address - Country:US
Practice Address - Phone:856-482-2900
Practice Address - Fax:856-482-5127
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-09
Last Update Date:2016-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA046049002085R0202X
MI43010790442085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAG8865226OtherMEDICARE - WA
MI3105211271OtherBCBS OF MICHIGAN
WAG8865226OtherMEDICARE - WA
MI3105211271OtherBCBS OF MICHIGAN
NJ647943Medicare ID - Type Unspecified