Provider Demographics
NPI:1255627501
Name:GREENSTEIN, STEVEN (MD)
Entity type:Individual
Prefix:
First Name:STEVEN
Middle Name:
Last Name:GREENSTEIN
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 1:300 FRANK W BURR BLVD
Mailing Address - Street 2:
Mailing Address - City:TEANECK
Mailing Address - State:NJ
Mailing Address - Zip Code:07666-6704
Mailing Address - Country:US
Mailing Address - Phone:018-883-0505
Mailing Address - Fax:201-692-9646
Practice Address - Street 1:300 FRANK W BURR BLVD
Practice Address - Street 2:
Practice Address - City:TEANECK
Practice Address - State:NJ
Practice Address - Zip Code:07666
Practice Address - Country:US
Practice Address - Phone:201-883-0505
Practice Address - Fax:201-692-9646
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-24
Last Update Date:2018-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000000000000390200000X
NJ25MA09903400193400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes193400000XGroupSingle Specialty
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program