Provider Demographics
NPI:1366432734
Name:GREENSPAN, JAMES SCOTT (MD)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:SCOTT
Last Name:GREENSPAN
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 1:454 GLEN ST
Mailing Address - Street 2:ALBANY MED FACULTY PHYSICIANS NEUROSURGERY
Mailing Address - City:GLENS FALLS
Mailing Address - State:NY
Mailing Address - Zip Code:12801-2974
Mailing Address - Country:US
Mailing Address - Phone:518-264-0880
Mailing Address - Fax:518-264-0885
Practice Address - Street 1:454 GLEN ST
Practice Address - Street 2:ALBANY MED FACULTY PHYSICIANS NEUROSURGERY
Practice Address - City:GLENS FALLS
Practice Address - State:NY
Practice Address - Zip Code:12801-2974
Practice Address - Country:US
Practice Address - Phone:518-264-0880
Practice Address - Fax:518-264-0885
Is Sole Proprietor?:No
Enumeration Date:2005-10-26
Last Update Date:2014-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY206252207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01735771Medicaid
NYP00894383OtherRR MEDICARE
NY01735771Medicaid
NYJ400011209Medicare PIN