Provider Demographics
NPI:1265204473
Name:GREENFIELD, MARK AFAM (LMT)
Entity type:Individual
Prefix:
First Name:MARK
Middle Name:AFAM
Last Name:GREENFIELD
Suffix:
Gender:M
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:424 W END AVE APT 6B
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10024-5777
Mailing Address - Country:US
Mailing Address - Phone:917-836-2610
Mailing Address - Fax:
Practice Address - Street 1:530 7TH AVE RM 908
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10018-4838
Practice Address - Country:US
Practice Address - Phone:212-729-3970
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-23
Last Update Date:2023-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY017466-01225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist