Provider Demographics
NPI:1194173781
Name:GREENBERGER, BENJAMIN AARON (MD)
Entity type:Individual
Prefix:
First Name:BENJAMIN
Middle Name:AARON
Last Name:GREENBERGER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2500 W 12TH ST
Mailing Address - Street 2:
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16505-4500
Mailing Address - Country:US
Mailing Address - Phone:814-836-2600
Mailing Address - Fax:
Practice Address - Street 1:2500 W 12TH ST
Practice Address - Street 2:
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16505-4500
Practice Address - Country:US
Practice Address - Phone:814-836-2600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-05-25
Last Update Date:2025-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD4733892085R0203X
PAMT212803390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Yes2085R0203XAllopathic & Osteopathic PhysiciansRadiologyTherapeutic Radiology