Provider Demographics
NPI:1518913672
Name:GREENSPAN, ALAN HOWARD (MD)
Entity Type:Individual
Prefix:DR
First Name:ALAN
Middle Name:HOWARD
Last Name:GREENSPAN
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 1:39 BROADWAY
Mailing Address - Street 2:SUITE 3005
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10006-3003
Mailing Address - Country:US
Mailing Address - Phone:212-509-5200
Mailing Address - Fax:212-425-0235
Practice Address - Street 1:39 BROADWAY
Practice Address - Street 2:SUITE 3005
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10006-3003
Practice Address - Country:US
Practice Address - Phone:212-509-5200
Practice Address - Fax:212-425-0235
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-26
Last Update Date:2018-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY146086207NS0135X, 207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
No207NS0135XAllopathic & Osteopathic PhysiciansDermatologyProcedural Dermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY47D451Medicare ID - Type Unspecified
NYA62895Medicare UPIN