Healthcare Provider Details

I. General information

NPI: 1841359098
Provider Name (Legal Business Name): NOAH GREENSPAN DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/06/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22 W 38TH ST
NEW YORK NY
10018-6262
US

IV. Provider business mailing address

22 W 38TH ST
NEW YORK NY
10018-6262
US

V. Phone/Fax

Practice location:
  • Phone: 212-921-0214
  • Fax: 212-921-0217
Mailing address:
  • Phone: 212-921-0214
  • Fax: 212-921-0217

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number012954
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code2251C2600X
TaxonomyCardiopulmonary Physical Therapist
License Number012954
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: