Provider Demographics
NPI:1689730269
Name:GREENE, JENNIFER YVONNE (MD)
Entity Type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:YVONNE
Last Name:GREENE
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:57 WILLOWBROOK BLVD
Mailing Address - Street 2:SECOND FLOOR
Mailing Address - City:WAYNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07470-7045
Mailing Address - Country:US
Mailing Address - Phone:973-754-4000
Mailing Address - Fax:973-754-4003
Practice Address - Street 1:57 WILLOWBROOK BLVD
Practice Address - Street 2:SECOND FLOOR
Practice Address - City:WAYNE
Practice Address - State:NJ
Practice Address - Zip Code:07470-7045
Practice Address - Country:US
Practice Address - Phone:973-754-4000
Practice Address - Fax:973-754-4003
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ025MA06835500207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology