Provider Demographics
NPI:1801123112
Name:VINCENZES GREENBERG, DEBRA A
Entity type:Individual
Prefix:MRS
First Name:DEBRA
Middle Name:A
Last Name:VINCENZES GREENBERG
Suffix:
Gender:F
Credentials:
Other - Prefix:MISS
Other - First Name:DEBRA
Other - Middle Name:A
Other - Last Name:VINCENZES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:527 KIMBALL AVE
Mailing Address - Street 2:
Mailing Address - City:WESTFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07090-2444
Mailing Address - Country:US
Mailing Address - Phone:908-654-7456
Mailing Address - Fax:908-654-1042
Practice Address - Street 1:2250 HICKORY RD
Practice Address - Street 2:SUITE 240
Practice Address - City:PLYMOUTH MEETING
Practice Address - State:PA
Practice Address - Zip Code:19462-1047
Practice Address - Country:US
Practice Address - Phone:908-654-7456
Practice Address - Fax:908-654-1042
Is Sole Proprietor?:No
Enumeration Date:2009-11-06
Last Update Date:2009-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ46TR00243200225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist