Provider Demographics
NPI:1225597438
Name:GREENFIELD, BETHANY SAUNDERS (PT)
Entity Type:Individual
Prefix:
First Name:BETHANY
Middle Name:SAUNDERS
Last Name:GREENFIELD
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:52 MINNEHAHA PATH
Mailing Address - Street 2:
Mailing Address - City:LINCOLN PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07035-2311
Mailing Address - Country:US
Mailing Address - Phone:973-975-7639
Mailing Address - Fax:
Practice Address - Street 1:503 PINE BROOK RD
Practice Address - Street 2:
Practice Address - City:LINCOLN PARK
Practice Address - State:NJ
Practice Address - Zip Code:07035-1801
Practice Address - Country:US
Practice Address - Phone:973-317-7500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-18
Last Update Date:2019-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA01576900225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist