Provider Demographics
NPI:1790940740
Name:GREENBERG, SUZAN BETH (PSYD)
Entity Type:Individual
Prefix:DR
First Name:SUZAN
Middle Name:BETH
Last Name:GREENBERG
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:146 MONTGOMERY AVE
Mailing Address - Street 2:SUITE 301
Mailing Address - City:BALA CYNWYD
Mailing Address - State:PA
Mailing Address - Zip Code:19004-2956
Mailing Address - Country:US
Mailing Address - Phone:215-735-3540
Mailing Address - Fax:610-668-1992
Practice Address - Street 1:146 MONTGOMERY AVE
Practice Address - Street 2:SUITE 301
Practice Address - City:BALA CYNWYD
Practice Address - State:PA
Practice Address - Zip Code:19004-2956
Practice Address - Country:US
Practice Address - Phone:215-735-3540
Practice Address - Fax:610-668-1992
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-18
Last Update Date:2008-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS004798L103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical