Provider Demographics
NPI:1003973322
Name:GREENE, KAREN JULIE (PHD)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:JULIE
Last Name:GREENE
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 566
Mailing Address - Street 2:
Mailing Address - City:ORANGEBURG
Mailing Address - State:NY
Mailing Address - Zip Code:10962-0566
Mailing Address - Country:US
Mailing Address - Phone:212-781-3967
Mailing Address - Fax:845-680-7792
Practice Address - Street 1:123 W 79TH ST
Practice Address - Street 2:SUITE LL6
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10024-6480
Practice Address - Country:US
Practice Address - Phone:212-781-3967
Practice Address - Fax:845-680-7792
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-03
Last Update Date:2010-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY9866103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical