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Individual

DR. RENA MATISON GREENBLATT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PHD

Contact information

Practice address
1160 FIFTH AVENUE, STE 112, NEW YORK, NY 10029
(212) 828-7574
Mailing address
1160 FIFTH AVENUE, NEW YORK, NY 10029

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
0091801
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
005235199
GHI
NY
Enumeration date
06/15/2007
Last updated
02/22/2012
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