Provider Demographics
NPI:1669783205
Name:GREENHOUSE INTERNISTS, PC
Entity type:Organization
Organization Name:GREENHOUSE INTERNISTS, PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:J
Authorized Official - Last Name:BARON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:215-242-5000
Mailing Address - Street 1:345 E MOUNT AIRY AVE
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19119-1114
Mailing Address - Country:US
Mailing Address - Phone:215-242-5000
Mailing Address - Fax:215-242-3951
Practice Address - Street 1:8200 FLOURTOWN AVE
Practice Address - Street 2:SUITE 14
Practice Address - City:WYNDMOOR
Practice Address - State:PA
Practice Address - Zip Code:19038-7976
Practice Address - Country:US
Practice Address - Phone:215-242-5000
Practice Address - Fax:215-242-3951
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:GREENHOUSE INTERNISTS, PC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-06-29
Last Update Date:2010-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
B40250Medicare UPIN
H69339Medicare UPIN
G85143Medicare UPIN
C39637Medicare UPIN
H19410Medicare UPIN