Provider Demographics
NPI:1346354404
Name:GREENSTEIN, MARC S (DO)
Entity type:Individual
Prefix:
First Name:MARC
Middle Name:S
Last Name:GREENSTEIN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:601 ELMWOOD AVE BOX 668
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14642-0001
Mailing Address - Country:US
Mailing Address - Phone:585-671-6790
Mailing Address - Fax:
Practice Address - Street 1:3101 W RIDGE RD
Practice Address - Street 2:BUILDING D
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14626-3249
Practice Address - Country:US
Practice Address - Phone:585-225-1580
Practice Address - Fax:585-225-2040
Is Sole Proprietor?:No
Enumeration Date:2006-08-18
Last Update Date:2023-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY190045207VG0400X, 207VF0040X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VF0040XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyUrogynecology and Reconstructive Pelvic Surgery
No207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01796854Medicaid
NY35G051Medicare ID - Type Unspecified
NY01796854Medicaid