Provider Demographics
NPI:1619946464
Name:GLEEKMAN-GREENBERG, HILARY A (MD)
Entity Type:Individual
Prefix:
First Name:HILARY
Middle Name:A
Last Name:GLEEKMAN-GREENBERG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:51 MADISON AVE
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10010-1603
Mailing Address - Country:US
Mailing Address - Phone:212-576-6102
Mailing Address - Fax:
Practice Address - Street 1:51 MADISON AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10010-1603
Practice Address - Country:US
Practice Address - Phone:212-576-6102
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-15
Last Update Date:2010-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY183611207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01399917Medicaid
NY01399917Medicaid
NY40K833Medicare ID - Type Unspecified