Provider Demographics
NPI:1649419771
Name:TOBI GREENE, MD LLC
Entity Type:Organization
Organization Name:TOBI GREENE, MD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SURGEON
Authorized Official - Prefix:
Authorized Official - First Name:TOBI
Authorized Official - Middle Name:BETH
Authorized Official - Last Name:GREENE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:516-639-3142
Mailing Address - Street 1:209 E 56TH ST
Mailing Address - Street 2:APT 9E
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10022-3705
Mailing Address - Country:US
Mailing Address - Phone:201-820-4400
Mailing Address - Fax:291-820-4397
Practice Address - Street 1:20 PROSPECT AVE
Practice Address - Street 2:SUITE 503
Practice Address - City:HACKENSACK
Practice Address - State:NJ
Practice Address - Zip Code:07601-1997
Practice Address - Country:US
Practice Address - Phone:201-820-4400
Practice Address - Fax:201-820-4397
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-12
Last Update Date:2009-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA08144200208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1861501009OtherNPI
NJ103853 DHKMedicare UPIN