Provider Demographics
NPI:1730241357
Name:GREENBERG, LOREN SHARI (MS, MD)
Entity type:Individual
Prefix:DR
First Name:LOREN
Middle Name:SHARI
Last Name:GREENBERG
Suffix:
Gender:F
Credentials:MS, MD
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Mailing Address - Street 1:1450 CHAPEL ST
Mailing Address - Street 2:
Mailing Address - City:NEW HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06511-4405
Mailing Address - Country:US
Mailing Address - Phone:203-688-2204
Mailing Address - Fax:203-688-3876
Practice Address - Street 1:1450 CHAPEL ST
Practice Address - Street 2:
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06511-4405
Practice Address - Country:US
Practice Address - Phone:203-688-2204
Practice Address - Fax:203-688-3876
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-14
Last Update Date:2024-01-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY211288207RG0300X
CT66568207RG0300X, 207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYH41903Medicare UPIN