Provider Demographics
NPI:1679624274
Name:GREENBERGER, JUDY PEARL (LMFT, RN, MSN, HNC)
Entity Type:Individual
Prefix:
First Name:JUDY
Middle Name:PEARL
Last Name:GREENBERGER
Suffix:
Gender:F
Credentials:LMFT, RN, MSN, HNC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1981 BAYBERRY AVE
Mailing Address - Street 2:
Mailing Address - City:MERRICK
Mailing Address - State:NY
Mailing Address - Zip Code:11566-5554
Mailing Address - Country:US
Mailing Address - Phone:516-623-3023
Mailing Address - Fax:516-623-3023
Practice Address - Street 1:1981 BAYBERRY AVE
Practice Address - Street 2:
Practice Address - City:MERRICK
Practice Address - State:NY
Practice Address - Zip Code:11566-5554
Practice Address - Country:US
Practice Address - Phone:516-623-3023
Practice Address - Fax:516-623-3023
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000370106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist