Provider Demographics
NPI:1710762521
Name:GREENBERG, EMILY M
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:M
Last Name:GREENBERG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6318 ROSELAWN AVE
Mailing Address - Street 2:
Mailing Address - City:REYNOLDSBURG
Mailing Address - State:OH
Mailing Address - Zip Code:43068-2731
Mailing Address - Country:US
Mailing Address - Phone:614-323-3884
Mailing Address - Fax:
Practice Address - Street 1:6318 ROSELAWN AVE
Practice Address - Street 2:
Practice Address - City:REYNOLDSBURG
Practice Address - State:OH
Practice Address - Zip Code:43068-2731
Practice Address - Country:US
Practice Address - Phone:614-323-3884
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-29
Last Update Date:2023-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker