Individual
BLAINE S GREENWALD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
7559 263RD ST, GLEN OAKS, NY 11004-1150
(718) 470-8011
(718) 962-8537
Mailing address
7559 263RD ST, GLEN OAKS, NY 11004-1150
(718) 470-8011
(718) 962-8537
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
141018
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01134523
—
NY
Enumeration date
12/22/2006
Last updated
07/08/2007
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