Provider Demographics
NPI:1578650156
Name:PAUL A. GREENE, PHD PSYCHOLOGIST PC
Entity Type:Organization
Organization Name:PAUL A. GREENE, PHD PSYCHOLOGIST PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:ARTHUR
Authorized Official - Last Name:GREENE
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:914-235-6171
Mailing Address - Street 1:68 LAMBERT LN
Mailing Address - Street 2:
Mailing Address - City:NEW ROCHELLE
Mailing Address - State:NY
Mailing Address - Zip Code:10804-1010
Mailing Address - Country:US
Mailing Address - Phone:914-235-6171
Mailing Address - Fax:
Practice Address - Street 1:68 LAMBERT LN
Practice Address - Street 2:
Practice Address - City:NEW ROCHELLE
Practice Address - State:NY
Practice Address - Zip Code:10804-1010
Practice Address - Country:US
Practice Address - Phone:914-235-6171
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-06
Last Update Date:2009-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY005968103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYV1556200Medicare ID - Type Unspecified