Provider Demographics
NPI:1164790705
Name:GREENBERG, ESTEE RENEE (OTR)
Entity Type:Individual
Prefix:MRS
First Name:ESTEE
Middle Name:RENEE
Last Name:GREENBERG
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:833 OLIVER ST
Mailing Address - Street 2:
Mailing Address - City:WOODMERE
Mailing Address - State:NY
Mailing Address - Zip Code:11598-2319
Mailing Address - Country:US
Mailing Address - Phone:516-569-0816
Mailing Address - Fax:
Practice Address - Street 1:833 OLIVER ST
Practice Address - Street 2:
Practice Address - City:WOODMERE
Practice Address - State:NY
Practice Address - Zip Code:11598-2319
Practice Address - Country:US
Practice Address - Phone:516-569-0813
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-10
Last Update Date:2011-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY016969-1225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics