Healthcare Provider Details

I. General information

NPI: 1629125588
Provider Name (Legal Business Name): ANN TOBY GREENE ACSW LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ANN TOBY GONZALEZ

II. Dates (important events)

Enumeration Date: 01/04/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

925 CENTRAL AVENUE
PEEKSKILL NY
10566
US

IV. Provider business mailing address

157 DOGWOOD ROAD
CORTLANDT MANOR NY
10567
US

V. Phone/Fax

Practice location:
  • Phone: 914-659-7971
  • Fax:
Mailing address:
  • Phone: 914-736-2250
  • Fax: 914-736-2250

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberR0193191
License Number StateNY

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: