Provider Demographics
NPI:1730144817
Name:GREENE, ANTHONY F (PHD)
Entity Type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:F
Last Name:GREENE
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 1:1 FLETCHER DRIVE
Mailing Address - Street 2:SHCC
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32611-7500
Mailing Address - Country:US
Mailing Address - Phone:352-392-1161
Mailing Address - Fax:352-846-1030
Practice Address - Street 1:1 FLETCHER DRIVE
Practice Address - Street 2:SHCC,
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32611-7500
Practice Address - Country:US
Practice Address - Phone:352-392-1161
Practice Address - Fax:352-846-1030
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY4215103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist