Provider Demographics
NPI:1902803349
Name:GREENBERG, RICHARD HARVEY (MD)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:HARVEY
Last Name:GREENBERG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:221 LAUREL RD
Mailing Address - Street 2:STE 175
Mailing Address - City:VOORHEES
Mailing Address - State:NJ
Mailing Address - Zip Code:08043-2330
Mailing Address - Country:US
Mailing Address - Phone:856-424-3311
Mailing Address - Fax:
Practice Address - Street 1:221 LAUREL RD
Practice Address - Street 2:STE 175
Practice Address - City:VOORHEES
Practice Address - State:NJ
Practice Address - Zip Code:08043-2330
Practice Address - Country:US
Practice Address - Phone:856-424-3311
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-06-30
Last Update Date:2016-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA69257207RH0003X
NJ25MA06925700207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ7954301Medicaid
028274ARVMedicare ID - Type Unspecified
G23965Medicare UPIN