Provider Demographics
NPI:1477533172
Name:GREENBERG, SUSAN NANCY (MD)
Entity type:Individual
Prefix:DR
First Name:SUSAN
Middle Name:NANCY
Last Name:GREENBERG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:SUSAN
Other - Middle Name:GREENBERG
Other - Last Name:URAM
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:486 S BEACH RD
Mailing Address - Street 2:
Mailing Address - City:HOBE SOUND
Mailing Address - State:FL
Mailing Address - Zip Code:33455-2705
Mailing Address - Country:US
Mailing Address - Phone:732-778-7977
Mailing Address - Fax:732-530-3752
Practice Address - Street 1:486 S BEACH RD
Practice Address - Street 2:
Practice Address - City:HOBE SOUND
Practice Address - State:FL
Practice Address - Zip Code:33455-2705
Practice Address - Country:US
Practice Address - Phone:732-778-7977
Practice Address - Fax:732-530-3752
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-19
Last Update Date:2024-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA04275800207RH0003X
FLME153810207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ5274401Medicaid
NJC11873Medicare UPIN
NJ506122QDZMedicare ID - Type Unspecified