Individual
DR. DARRELL CORY GREENE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
1123 BROADWAY STE 916, NEW YORK, NY 10010-2007
(212) 929-5978
(646) 478-9404
Mailing address
444 BEARDS HOLLOW RD, RICHMONDVILLE, NY 12149-3407
(917) 421-0954
(646) 478-9404
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
012091-1
NY
103TA0400X
Addiction (Substance Use Disorder) Psychologist
012091-1
NY
103TC0700X
Clinical Psychologist
012091-1
NY
103TC1900X
Counseling Psychologist
012091-01
NY
103TF0000X
Family Psychologist
012091-1
NY
103TP2701X
Group Psychotherapy Psychologist
012091-1
NY
Other
Enumeration date
12/22/2006
Last updated
12/18/2020
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