Provider Demographics
NPI:1760474308
Name:GREENBERG, MARTIN JAY (MD)
Entity Type:Individual
Prefix:DR
First Name:MARTIN
Middle Name:JAY
Last Name:GREENBERG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:124 E MOUNT PLEASANT AVE
Mailing Address - Street 2:
Mailing Address - City:LIVINGSTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07039-3026
Mailing Address - Country:US
Mailing Address - Phone:973-994-4130
Mailing Address - Fax:973-994-2977
Practice Address - Street 1:124 E MOUNT PLEASANT AVE
Practice Address - Street 2:
Practice Address - City:LIVINGSTON
Practice Address - State:NJ
Practice Address - Zip Code:07039-3026
Practice Address - Country:US
Practice Address - Phone:973-994-4130
Practice Address - Fax:973-994-2977
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-19
Last Update Date:2008-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA48278207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJD18770Medicare UPIN