Provider Demographics
NPI:1619646262
Name:GREENBERG, SYDNEY (FNP, APRN)
Entity Type:Individual
Prefix:
First Name:SYDNEY
Middle Name:
Last Name:GREENBERG
Suffix:
Gender:F
Credentials:FNP, APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5249 OLDE TOWNE RD STE D
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:23188-8111
Mailing Address - Country:US
Mailing Address - Phone:757-259-3258
Mailing Address - Fax:757-220-1953
Practice Address - Street 1:5249 OLDE TOWNE RD STE D
Practice Address - Street 2:
Practice Address - City:WILLIAMSBURG
Practice Address - State:VA
Practice Address - Zip Code:23188-8111
Practice Address - Country:US
Practice Address - Phone:757-259-3258
Practice Address - Fax:757-220-1953
Is Sole Proprietor?:No
Enumeration Date:2021-09-08
Last Update Date:2021-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0001266603163W00000X
CT159813163W00000X
VA0024182084363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT159813OtherBOARD OF NURSING
VA0001266603OtherBOARD OF NURSING
VA0024182084OtherBOARD OF NURSIN