Provider Demographics
NPI:1134996861
Name:GREENTREE MEDICAL CENTER
Entity type:Organization
Organization Name:GREENTREE MEDICAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:C
Authorized Official - Last Name:CARABASSI
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:609-870-0724
Mailing Address - Street 1:1919 GREENTREE RD STE A
Mailing Address - Street 2:
Mailing Address - City:CHERRY HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08003-1115
Mailing Address - Country:US
Mailing Address - Phone:856-761-8100
Mailing Address - Fax:856-761-8107
Practice Address - Street 1:1919 GREENTREE RD STE A
Practice Address - Street 2:
Practice Address - City:CHERRY HILL
Practice Address - State:NJ
Practice Address - Zip Code:08003-1115
Practice Address - Country:US
Practice Address - Phone:856-761-8100
Practice Address - Fax:856-761-8107
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-04
Last Update Date:2023-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty
No111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty