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NPI 1013225101

NPI 1013225101 : SHIRA GREENBLATT M.S.ED : VALLEY STREAM, NY

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General NPI Number Information
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    NPI Number           |    1013225101
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    Entity Type          |    Individual 
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    Provider Name        |    SHIRA GREENBLATT M.S.ED
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    09/22/2010
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    Last Update Date     |    09/22/2010
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Provider Practice Location Address
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    Address Line         |    50 HUNGRY HARBOR RD 
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    City                 |    VALLEY STREAM
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    State                |    NY
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    Zip                  |    11581-2511
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    Country              |    US
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    Telephone            |    516-791-5315
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    15 SHERIDAN CT 
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    City                 |    PLAINVIEW
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    State                |    NY
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    Zip                  |    11803-5216
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    Country              |    US
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    Telephone            |    516-433-3771
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    Fax                  |    
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    103TS0200X
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    Taxonomy Name        |    School Psychologist
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    License Number       |    845316
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    License Number State |    NY
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