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Individual

JASON GREENBERG

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PH.D.

Contact information

Practice address
910 W END AVE, 1C, NEW YORK, NY 10025-3533
(212) 851-8100
(212) 932-0964
Mailing address
151 REMSEN ST, 5R, BROOKLYN, NY 11201-4316
(646) 425-4285

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
15300
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
02587039
NY
Enumeration date
07/27/2006
Last updated
07/08/2007
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