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General NPI Number Information
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NPI Number | 1851415699
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Entity Type | Individual
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Provider Name | JUDITH LYNN GREENBERG LCSW
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Gender | Female
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Dates
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Enumeration Date | 03/19/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 109 EAST 36 STREET STE. 5R
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City | NEW YORK
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State | NY
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Zip | 10016
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Country | US
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Telephone | 212-873-4705
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Fax |
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Provider Business Mailing Address
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Address Line | 210 WEST 89 STREET APT. 1C
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City | NEW YORK
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State | NY
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Zip | 10024-1803
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Country | US
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Telephone | 212-873-4705
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | PRO 13422-1
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License Number State | NY
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