Greenwich Street Medical P.C.

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

Legal business name

GREENWICH STREET MEDICAL P.C.

Practice address

315 Madison Ave
New York, NY 10017-5405

Phone

(914) 582-0479

NPI assigned

Oct 19, 2012

Organization subpart

No

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

Authorized official

Name

Jack Bruder, M.D.

Title

President

Phone

(914) 582-0749

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1350604800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1350604800000",
    "number": "1588917140",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 284H",
            "city": "SCARSDALE",
            "state": "NY",
            "postal_code": "105838784"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "315 MADISON AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100175405",
            "telephone_number": "914-582-0479"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREENWICH STREET MEDICAL P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-10-19",
        "last_updated": "2012-10-19",
        "status": "A",
        "authorized_official_last_name": "BRUDER",
        "authorized_official_first_name": "JACK",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "914-582-0749",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Greenwich House Inc
• Greenwich Medical Anesthesia, P.C.
• Greenwich OB/GYN Medical P.C.
• Greenwich Psychology PLLC
• Greenwich Street Medical Aesthetics, PLLC (Greenwich Street Surgical)
• Greenwich Street Medical Services of New York PC
• Greenwich Village Ambulatory Surgery Center, LLC
• Greenwich Village Dental Arts PC (Advanced Dental Arts)
• Greenwich Village GYN, P.C.
• Greenwich Village Medical Group, PC

• Diagnostic Radiology Physician in New York, NY
• Providers in New York, NY by specialty
• Diagnostic Radiology Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2012; 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.