MEDICARE: DAVID J GREENE LCSW

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	1041C0700X	Clinical Social Worker	44SC05935200	NJ

General Provider Information

NPI Number	:	1568072619
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAVID J GREENE LCSW

Provider Business Mailing Address
First Line	:	7 ELY PL
Second Line	:
City	:	EDISON
State	:	NJ
Zip	:	08817-3005
Country	:	US
Telephone Number	:	917-936-6288
Fax Number	:

Provider Business Practice Location Address
First Line	:	7 BARLOW RD
Second Line	:
City	:	EDISON
State	:	NJ
Zip	:	08817-3022
Country	:	US
Telephone Number	:	732-535-7343
Fax Number	:	732-503-8962

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

Provider Enumeration Date	:	08/04/2020
Last Update Date	:	01/09/2022

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Directions to “ DAVID J GREENE LCSW” Practice Location

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