Provider Demographics
NPI:1003972324
Name:GREENBERG, ANN (PHD)
Entity Type:Individual
Prefix:DR
First Name:ANN
Middle Name:
Last Name:GREENBERG
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:ANN
Other - Middle Name:
Other - Last Name:CORE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHD
Mailing Address - Street 1:15 SACHEM RD
Mailing Address - Street 2:
Mailing Address - City:GREENWICH
Mailing Address - State:CT
Mailing Address - Zip Code:06830-7230
Mailing Address - Country:US
Mailing Address - Phone:203-661-7062
Mailing Address - Fax:203-661-7062
Practice Address - Street 1:105 S MADISON AVE
Practice Address - Street 2:
Practice Address - City:SPRING VALLEY
Practice Address - State:NY
Practice Address - Zip Code:10977-5474
Practice Address - Country:US
Practice Address - Phone:845-577-6018
Practice Address - Fax:845-577-6059
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-29
Last Update Date:2019-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT1836103T00000X
NY010648103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103T00000XBehavioral Health & Social Service ProvidersPsychologist