Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
DR. JACK M GREENWOOD, MD
Active Sole ProprietorDR. JACK M GREENWOOD, MD is a Neurology with Special Qualifications in Child Neurology healthcare provider located in PORT JEFFERSON, New York. NPI 1851396865 is currently active in the NPPES registry. Verify at CMS.
Neurology with Special Qualifications in Child Neurology · PORT JEFFERSON, NY
Registration Details
- NPI Number
- 1851396865
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Jun 16, 2005 (21.208880852218 yrs)
- Last Updated
- Apr 2, 2008
- License
-
124686 (NY)
- Sole Proprietor
- Yes
Practice Information
- Address
-
120 N COUNTRY RDPORT JEFFERSON, NY, 117772604Browse NY providers · Browse ZIP 11777
- Phone
- 6314740444
- Fax
- 6319288605
- Primary Specialty
-
Neurology with Special Qualifications in Child Neurology
2084N0402X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.