Healthcare Provider Details

I. General information

NPI: 1548282361
Provider Name (Legal Business Name): DAVID GREENFIELD P.T.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/24/2006
Last Update Date: 03/02/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1987 STATE ROUTE 52 SUITE 11
LIBERTY NY
12754-8316
US

IV. Provider business mailing address

40 SCENIC HILLS DR
POUGHKEEPSIE NY
12603-3723
US

V. Phone/Fax

Practice location:
  • Phone: 845-292-8580
  • Fax: 845-292-8909
Mailing address:
  • Phone: 845-242-8270
  • Fax: 845-215-0070

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License Number010664-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: