Provider Demographics
NPI:1811010192
Name:GREENWALD, DAVID STEPHEN (PHD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:STEPHEN
Last Name:GREENWALD
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 1:2006 WALNUT ST
Mailing Address - Street 2:SUITE 201
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19103-5608
Mailing Address - Country:US
Mailing Address - Phone:215-340-1554
Mailing Address - Fax:
Practice Address - Street 1:61 S PINE ST
Practice Address - Street 2:
Practice Address - City:DOYLESTOWN
Practice Address - State:PA
Practice Address - Zip Code:18901-4632
Practice Address - Country:US
Practice Address - Phone:215-340-1554
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-09
Last Update Date:2008-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS02572L103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical