MEDICARE: ESTHER M GREENWALD PMHNP-BC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	26NJ15061500	NJ

General Provider Information

NPI Number	:	1467208074
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ESTHER M GREENWALD PMHNP-BC

Provider Business Mailing Address
First Line	:	1980 SWARTHMORE AVE
Second Line	:
City	:	LAKEWOOD
State	:	NJ
Zip	:	08701-4692
Country	:	US
Telephone Number	:	732-503-8654
Fax Number	:	469-663-5802

Provider Business Practice Location Address
First Line	:	1980 SWARTHMORE AVE
Second Line	:
City	:	LAKEWOOD
State	:	NJ
Zip	:	08701-4692
Country	:	US
Telephone Number	:	732-503-8654
Fax Number	:	469-663-5802

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/24/2024
Last Update Date	:	12/24/2025

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