Provider Demographics
NPI:1366629891
Name:GREENE, KAMALA ALEXANDRIA (PHD)
Entity Type:Individual
Prefix:DR
First Name:KAMALA
Middle Name:ALEXANDRIA
Last Name:GREENE
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19 HAMILTON TER
Mailing Address - Street 2:4-E
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10031-6404
Mailing Address - Country:US
Mailing Address - Phone:917-803-0719
Mailing Address - Fax:
Practice Address - Street 1:321 E TREMONT AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10457-5304
Practice Address - Country:US
Practice Address - Phone:718-518-3700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-01-28
Last Update Date:2008-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY017290103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist