Provider Demographics
NPI:1447623434
Name:GREENFELD, JACOB (PHARM D)
Entity type:Individual
Prefix:
First Name:JACOB
Middle Name:
Last Name:GREENFELD
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:YAAKOV
Other - Middle Name:
Other - Last Name:GREENFELD
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:7005 137TH ST
Mailing Address - Street 2:GROUND FLOOR
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11367-1914
Mailing Address - Country:US
Mailing Address - Phone:216-534-4748
Mailing Address - Fax:
Practice Address - Street 1:8406 37TH AVE
Practice Address - Street 2:
Practice Address - City:JACKSON HEIGHTS
Practice Address - State:NY
Practice Address - Zip Code:11372-7339
Practice Address - Country:US
Practice Address - Phone:347-242-3124
Practice Address - Fax:347-242-3120
Is Sole Proprietor?:No
Enumeration Date:2015-11-12
Last Update Date:2019-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY060443183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
1447623434OtherNPI