MEDICARE: SARAH G. GREENBERG OTR/L

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225X00000X	Occupational Therapist	023532	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	878494147	OTHER	IL	PRIVATE INSURANCE

General Provider Information

NPI Number	:	1073164976
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SARAH G. GREENBERG OTR/L

Provider Business Mailing Address
First Line	:	575 8TH AVE FL 6
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10018-3158
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	435 CENTRAL PARK W APT 5A
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10025-4349
Country	:	US
Telephone Number	:	312-806-7130
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/23/2019
Last Update Date	:	09/23/2019

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