Healthcare Provider Details

I. General information

NPI: 1467208074
Provider Name (Legal Business Name): ESTHER M GREENWALD PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/24/2024
Last Update Date: 12/24/2025
Certification Date: 12/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1980 SWARTHMORE AVE
LAKEWOOD NJ
08701-4692
US

IV. Provider business mailing address

1980 SWARTHMORE AVE
LAKEWOOD NJ
08701-4692
US

V. Phone/Fax

Practice location:
  • Phone: 732-503-8654
  • Fax: 469-663-5802
Mailing address:
  • Phone: 732-503-8654
  • Fax: 469-663-5802

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number26NJ15061500
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: