Provider Demographics
NPI:1144303496
Name:GREENFOGEL, STEPHEN IRA (DPM)
Entity type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:IRA
Last Name:GREENFOGEL
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50 CHERRY HILL RD
Mailing Address - Street 2:SUITE 206
Mailing Address - City:PARSIPPANY
Mailing Address - State:NJ
Mailing Address - Zip Code:07054
Mailing Address - Country:US
Mailing Address - Phone:973-334-1770
Mailing Address - Fax:973-334-2217
Practice Address - Street 1:50 CHERRY HILL RD
Practice Address - Street 2:SUITE 206
Practice Address - City:PARSIPPANY
Practice Address - State:NJ
Practice Address - Zip Code:07054
Practice Address - Country:US
Practice Address - Phone:973-334-1770
Practice Address - Fax:973-334-2217
Is Sole Proprietor?:No
Enumeration Date:2006-10-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MD00131500213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
T45031Medicare UPIN
445090Medicare ID - Type Unspecified