Provider Demographics
NPI:1437385820
Name:GREENE&JENSEN SPEECH&BEHAVIOR SERVICES
Entity Type:Organization
Organization Name:GREENE&JENSEN SPEECH&BEHAVIOR SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:P
Authorized Official - Last Name:JENSEN
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:845-210-1161
Mailing Address - Street 1:300 VISCOMI RD
Mailing Address - Street 2:
Mailing Address - City:GRAHAMSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:12740-5948
Mailing Address - Country:US
Mailing Address - Phone:845-985-2958
Mailing Address - Fax:845-985-2958
Practice Address - Street 1:300 VISCOMI RD
Practice Address - Street 2:
Practice Address - City:GRAHAMSVILLE
Practice Address - State:NY
Practice Address - Zip Code:12740-5948
Practice Address - Country:US
Practice Address - Phone:845-985-2958
Practice Address - Fax:845-985-2958
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-31
Last Update Date:2009-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY003671-1252Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency