Provider Demographics
NPI:1295819399
Name:GREENBAUM, RICHARD R (PHD)
Entity type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:R
Last Name:GREENBAUM
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 1:27545 WESTPOINT RD
Mailing Address - Street 2:
Mailing Address - City:EASTON
Mailing Address - State:MD
Mailing Address - Zip Code:21601-8441
Mailing Address - Country:US
Mailing Address - Phone:410-820-7540
Mailing Address - Fax:
Practice Address - Street 1:8706 COMMERCE DR
Practice Address - Street 2:
Practice Address - City:EASTON
Practice Address - State:MD
Practice Address - Zip Code:21601-6903
Practice Address - Country:US
Practice Address - Phone:410-820-7286
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist