Provider Demographics
NPI:1356464150
Name:GREENWALD, SARA ELLEN (MD)
Entity Type:Individual
Prefix:DR
First Name:SARA
Middle Name:ELLEN
Last Name:GREENWALD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:SENNA
Other - Middle Name:
Other - Last Name:GREENWALD
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:6410 ROCKLEDGE DR
Mailing Address - Street 2:SUITE 307
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20817-1809
Mailing Address - Country:US
Mailing Address - Phone:301-564-4512
Mailing Address - Fax:301-564-4512
Practice Address - Street 1:6410 ROCKLEDGE DR
Practice Address - Street 2:SUITE 307
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20817-1809
Practice Address - Country:US
Practice Address - Phone:301-564-4512
Practice Address - Fax:301-564-4512
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD00391542084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry