Provider Demographics
NPI:1548488349
Name:SHARON GREENBERG, MD PC
Entity type:Organization
Organization Name:SHARON GREENBERG, MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:
Authorized Official - Last Name:GREENBERG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-428-9393
Mailing Address - Street 1:5444 LITTLE NECK PKWY
Mailing Address - Street 2:SUITE 3
Mailing Address - City:LITTLE NECK
Mailing Address - State:NY
Mailing Address - Zip Code:11362-2211
Mailing Address - Country:US
Mailing Address - Phone:718-428-9393
Mailing Address - Fax:718-428-8738
Practice Address - Street 1:5444 LITTLE NECK PKWY
Practice Address - Street 2:SUITE 3
Practice Address - City:LITTLE NECK
Practice Address - State:NY
Practice Address - Zip Code:11362-2211
Practice Address - Country:US
Practice Address - Phone:718-428-9393
Practice Address - Fax:718-428-8738
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY151309174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY06495Medicare ID - Type Unspecified