Provider Demographics
NPI:1538246228
Name:JUDITH GREENBERG
Entity type:Organization
Organization Name:JUDITH GREENBERG
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JUDITH
Authorized Official - Middle Name:
Authorized Official - Last Name:GREENBERG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-594-9500
Mailing Address - Street 1:P.O. BOX 1568
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:MI
Mailing Address - Zip Code:48012-1568
Mailing Address - Country:US
Mailing Address - Phone:248-594-9500
Mailing Address - Fax:248-594-9599
Practice Address - Street 1:725 S. ADAMS RD
Practice Address - Street 2:SUITE 188
Practice Address - City:BIRMINGHAM
Practice Address - State:MI
Practice Address - Zip Code:48000
Practice Address - Country:US
Practice Address - Phone:248-594-9500
Practice Address - Fax:248-594-9599
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI16010000067332S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332S00000XSuppliersHearing Aid Equipment