Individual provider Active NPI

Beth Ilene Greenberg, M.D.

  • Health Maintenance Organization
  • Newark, NJ
National Provider Identifier
1306925664
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health Maintenance OrganizationTaxonomy code 302R00000X
License
25MA07715800 Issued in NJ
Practice address
3 Penn PLZ E # PP-14B
Newark, NJ 07105-2258
Phone
(973) 466-7381
NPI assigned
Nov 6, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Health Maintenance Organization 302R00000X 25MA07715800 NJ Primary

Addresses

Primary practice location

3 Penn PLZ E # PP-14B
Newark, NJ 07105-2258

Mailing address

12 W 18TH St
Apt 9E
New York, NY 10011-4614
Phone (212) 242-3404

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
25MA07715800NJMDHealth Maintenance Organization

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1162771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1306925664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 W 18TH ST",
            "address_2": "APT 9E",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100114614",
            "telephone_number": "212-242-3404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 PENN PLZ E # PP-14B",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071052258",
            "telephone_number": "973-466-7381"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREENBERG",
        "first_name": "BETH",
        "middle_name": "ILENE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-06",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "302R00000X",
            "taxonomy_group": "",
            "desc": "Health Maintenance Organization",
            "state": "NJ",
            "license": "25MA07715800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newark, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.