Provider Demographics
NPI:1831569623
Name:PHILIP A. GREENHILL M.D.P.C.
Entity type:Organization
Organization Name:PHILIP A. GREENHILL M.D.P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:PHILIP
Authorized Official - Middle Name:ARTHUR
Authorized Official - Last Name:GREENHILL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:973-584-0400
Mailing Address - Street 1:151 ROUTE 10
Mailing Address - Street 2:SUITE 106
Mailing Address - City:SUCCASUNNA
Mailing Address - State:NJ
Mailing Address - Zip Code:07876-1452
Mailing Address - Country:US
Mailing Address - Phone:973-584-0400
Mailing Address - Fax:973-584-6090
Practice Address - Street 1:151 ROUTE 10
Practice Address - Street 2:SUITE 106
Practice Address - City:SUCCASUNNA
Practice Address - State:NJ
Practice Address - Zip Code:07876-1452
Practice Address - Country:US
Practice Address - Phone:973-584-0400
Practice Address - Fax:973-584-6090
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-06
Last Update Date:2015-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ3457605Medicaid