Provider Demographics
NPI:1174646525
Name:GREIF, JASON DANIEL (PSYD)
Entity Type:Individual
Prefix:DR
First Name:JASON
Middle Name:DANIEL
Last Name:GREIF
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:142 W END AVE
Mailing Address - Street 2:SUITE 1-S
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10023-6103
Mailing Address - Country:US
Mailing Address - Phone:917-621-7913
Mailing Address - Fax:
Practice Address - Street 1:142 W END AVE
Practice Address - Street 2:SUITE 1-S
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10023-6103
Practice Address - Country:US
Practice Address - Phone:917-621-7913
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-09
Last Update Date:2013-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY015819103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical