Provider Demographics
NPI:1245325034
Name:GREISS, KAMAL (MD)
Entity type:Individual
Prefix:DR
First Name:KAMAL
Middle Name:
Last Name:GREISS
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 1:710 OAK LN
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN LAKES
Mailing Address - State:NJ
Mailing Address - Zip Code:07417-2309
Mailing Address - Country:US
Mailing Address - Phone:201-451-1441
Mailing Address - Fax:201-451-1088
Practice Address - Street 1:75 MONTGOMERY ST
Practice Address - Street 2:
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07302-3726
Practice Address - Country:US
Practice Address - Phone:201-451-1441
Practice Address - Fax:201-451-1088
Is Sole Proprietor?:No
Enumeration Date:2006-10-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ80238207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ2893207Medicaid
NJ2893207Medicaid
NJD18589Medicare UPIN