Provider Demographics
NPI:1437486776
Name:GREENBERG, CAROL S (PT,MA)
Entity Type:Individual
Prefix:MS
First Name:CAROL
Middle Name:S
Last Name:GREENBERG
Suffix:
Gender:F
Credentials:PT,MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:103 E. 86TH ST.#7D
Mailing Address - Street 2:
Mailing Address - City:NEW Y ORK
Mailing Address - State:NY
Mailing Address - Zip Code:10028
Mailing Address - Country:US
Mailing Address - Phone:212-772-6524
Mailing Address - Fax:212-289-5178
Practice Address - Street 1:103 E 86TH ST # 7D
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10028-1058
Practice Address - Country:US
Practice Address - Phone:212-772-6524
Practice Address - Fax:212-289-5178
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-06
Last Update Date:2009-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY001848172M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172M00000XOther Service ProvidersMechanotherapist