Provider Demographics
NPI:1730274796
Name:GREENFIELD, EFREM LEWIS (MD)
Entity type:Individual
Prefix:MR
First Name:EFREM
Middle Name:LEWIS
Last Name:GREENFIELD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:EFREM
Other - Middle Name:L
Other - Last Name:GREENFIELD
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:14 SECOND AVENUE
Mailing Address - Street 2:
Mailing Address - City:DENVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:07834
Mailing Address - Country:US
Mailing Address - Phone:973-625-8454
Mailing Address - Fax:973-625-8465
Practice Address - Street 1:14 SECOND AVENUE
Practice Address - Street 2:
Practice Address - City:DENVILLE
Practice Address - State:NJ
Practice Address - Zip Code:07834
Practice Address - Country:US
Practice Address - Phone:973-625-8454
Practice Address - Fax:973-625-8465
Is Sole Proprietor?:No
Enumeration Date:2006-10-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA052631PEDIATRICIAN208000000X
NY174115208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
E94799Medicare UPIN
NJE94799Medicare ID - Type Unspecified