Provider Demographics
NPI:1518997576
Name:GREENWALD, MICHAEL ALAN (PHD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:ALAN
Last Name:GREENWALD
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1326 FREEPORT RD
Mailing Address - Street 2:SUITE 250
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15238-3131
Mailing Address - Country:US
Mailing Address - Phone:412-967-5650
Mailing Address - Fax:
Practice Address - Street 1:1326 FREEPORT RD
Practice Address - Street 2:SUITE 250
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15238-3131
Practice Address - Country:US
Practice Address - Phone:412-967-5650
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS2970L103TB0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & Behavioral