Provider Demographics
NPI:1770830143
Name:GREENSTEIN, BASYA (MSED)
Entity Type:Individual
Prefix:
First Name:BASYA
Middle Name:
Last Name:GREENSTEIN
Suffix:
Gender:F
Credentials:MSED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29 GITI RD
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08701-5630
Mailing Address - Country:US
Mailing Address - Phone:732-363-2943
Mailing Address - Fax:
Practice Address - Street 1:1950 RUTGERS UNIVERSITY BLVD
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08701-4537
Practice Address - Country:US
Practice Address - Phone:718-304-9977
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-08-05
Last Update Date:2020-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist