Provider Demographics
NPI:1083815591
Name:GREENBLATT, NAOMI HELEN
Entity Type:Individual
Prefix:DR
First Name:NAOMI
Middle Name:HELEN
Last Name:GREENBLATT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:NAOMI
Other - Middle Name:HELEN
Other - Last Name:VILKAS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:533 WINTHROP RD
Mailing Address - Street 2:
Mailing Address - City:TEANECK
Mailing Address - State:NJ
Mailing Address - Zip Code:07666-2970
Mailing Address - Country:US
Mailing Address - Phone:201-837-5105
Mailing Address - Fax:
Practice Address - Street 1:60 GRAND AVE
Practice Address - Street 2:
Practice Address - City:ENGLEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07631-3506
Practice Address - Country:US
Practice Address - Phone:201-658-8050
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-31
Last Update Date:2008-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA081949002084P0800X
NY2418242084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry