Provider Demographics
NPI:1699763144
Name:GREENSTEIN NEUROLOGY ASSOCIATES, P.C.
Entity type:Organization
Organization Name:GREENSTEIN NEUROLOGY ASSOCIATES, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT & CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:I
Authorized Official - Last Name:GREENSTEIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:267-597-3830
Mailing Address - Street 1:1341 N DELAWARE AVE
Mailing Address - Street 2:SUITE 212
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19125-4300
Mailing Address - Country:US
Mailing Address - Phone:267-597-3830
Mailing Address - Fax:267-597-3831
Practice Address - Street 1:1341 N DELAWARE AVE
Practice Address - Street 2:SUITE 212
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19125-4300
Practice Address - Country:US
Practice Address - Phone:267-597-3830
Practice Address - Fax:267-597-3831
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-10
Last Update Date:2012-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD-029200-E174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1372513OtherBLUE SHIELD PROV#
PA3Y2775-3556OtherELDERHEALTH & HEALTHNET
PA102626585 0001Medicaid
PA953670OtherPERSONAL CHOICE PROV#
PAP2669071OtherOXFORD PROVIDER #
PA2066290000OtherKHPE PROVIDER#
PA7350303OtherAETNA PROVIDER GROUP #
PAB41950Medicare UPIN
PA058051Medicare ID - Type UnspecifiedGROUP MEDICARE NUMBER
PA953670OtherPERSONAL CHOICE PROV#