Provider Demographics
NPI:1801152699
Name:GREENE, MARY ELIZABETH (MD)
Entity type:Individual
Prefix:DR
First Name:MARY
Middle Name:ELIZABETH
Last Name:GREENE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:465 CRANBURY RD STE 201
Mailing Address - Street 2:
Mailing Address - City:EAST BRUNSWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08816-7600
Mailing Address - Country:US
Mailing Address - Phone:732-613-1988
Mailing Address - Fax:732-613-1988
Practice Address - Street 1:465 CRANBURY RD STE 201
Practice Address - Street 2:
Practice Address - City:EAST BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08816-7600
Practice Address - Country:US
Practice Address - Phone:732-613-1988
Practice Address - Fax:732-613-1988
Is Sole Proprietor?:No
Enumeration Date:2012-04-05
Last Update Date:2020-01-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY286803207R00000X
NJ25MA10721700207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine