Provider Demographics
NPI:1952480337
Name:GREENBERG, LESLIE M (MD)
Entity Type:Individual
Prefix:DR
First Name:LESLIE
Middle Name:M
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:PO BOX 1591
Mailing Address - Street 2:
Mailing Address - City:PRINCETON
Mailing Address - State:NJ
Mailing Address - Zip Code:08542
Mailing Address - Country:US
Mailing Address - Phone:732-264-1127
Mailing Address - Fax:732-264-0670
Practice Address - Street 1:727 STATE ROAD
Practice Address - Street 2:
Practice Address - City:PRINCETON
Practice Address - State:NJ
Practice Address - Zip Code:08540
Practice Address - Country:US
Practice Address - Phone:609-924-8131
Practice Address - Fax:609-683-9146
Is Sole Proprietor?:No
Enumeration Date:2006-11-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA04239600207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ018680Medicare ID - Type Unspecified
D06333Medicare UPIN