Provider Demographics
NPI:1508876129
Name:NETZER-GREENFIELD, IRIS MIRIAM (LAC)
Entity Type:Individual
Prefix:
First Name:IRIS
Middle Name:MIRIAM
Last Name:NETZER-GREENFIELD
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 734
Mailing Address - Street 2:
Mailing Address - City:WESTPORT
Mailing Address - State:CT
Mailing Address - Zip Code:06881-0734
Mailing Address - Country:US
Mailing Address - Phone:917-744-4403
Mailing Address - Fax:309-214-6620
Practice Address - Street 1:201 E 56TH ST
Practice Address - Street 2:INFORM FITNESS
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10022
Practice Address - Country:US
Practice Address - Phone:212-991-8680
Practice Address - Fax:309-214-6620
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-08
Last Update Date:2016-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1388171100000X
CA6889171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist