Provider Demographics
NPI:1861449597
Name:GREENFIELD, GARRY (MD)
Entity Type:Individual
Prefix:
First Name:GARRY
Middle Name:
Last Name:GREENFIELD
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 1:35 CHARBONNEAU
Mailing Address - Street 2:
Mailing Address - City:BLAINVILLE
Mailing Address - State:QC
Mailing Address - Zip Code:J7E4H4
Mailing Address - Country:CA
Mailing Address - Phone:450-979-2180
Mailing Address - Fax:
Practice Address - Street 1:35 CHARBONNEAU
Practice Address - Street 2:
Practice Address - City:BLAINVILLE
Practice Address - State:QC
Practice Address - Zip Code:J7E4H4
Practice Address - Country:CA
Practice Address - Phone:450-979-2180
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA80892207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery