Provider Demographics
NPI:1114179124
Name:GREENBERG, AMY D (MSCCC-SLP)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:D
Last Name:GREENBERG
Suffix:
Gender:F
Credentials:MSCCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:230 SETON DR
Mailing Address - Street 2:
Mailing Address - City:NEW ROCHELLE
Mailing Address - State:NY
Mailing Address - Zip Code:10804-1523
Mailing Address - Country:US
Mailing Address - Phone:914-576-5323
Mailing Address - Fax:914-637-9372
Practice Address - Street 1:230 SETON DR
Practice Address - Street 2:
Practice Address - City:NEW ROCHELLE
Practice Address - State:NY
Practice Address - Zip Code:10804-1523
Practice Address - Country:US
Practice Address - Phone:914-576-5323
Practice Address - Fax:914-637-9372
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-21
Last Update Date:2008-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY005641235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist