Provider Demographics
NPI:1063852101
Name:GREENBERG, ALEXANDRA (DO)
Entity type:Individual
Prefix:MRS
First Name:ALEXANDRA
Middle Name:
Last Name:GREENBERG
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:525 JACK MARTIN BLVD STE 301
Mailing Address - Street 2:
Mailing Address - City:BRICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08724-7737
Mailing Address - Country:US
Mailing Address - Phone:732-840-0067
Mailing Address - Fax:732-840-3103
Practice Address - Street 1:525 JACK MARTIN BLVD STE 301
Practice Address - Street 2:
Practice Address - City:BRICK
Practice Address - State:NJ
Practice Address - Zip Code:08724-7737
Practice Address - Country:US
Practice Address - Phone:732-840-0067
Practice Address - Fax:732-840-3103
Is Sole Proprietor?:No
Enumeration Date:2013-07-03
Last Update Date:2024-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVD01784207R00000X
NJ25MB09979100207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine