Provider Demographics
NPI:1841496080
Name:GREENBLUM, LUCIE
Entity type:Individual
Prefix:DR
First Name:LUCIE
Middle Name:
Last Name:GREENBLUM
Suffix:
Gender:F
Credentials:
Other - Prefix:DR
Other - First Name:LUCIE
Other - Middle Name:GREENBLUM
Other - Last Name:HUTCHINSON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:5415 KIRKWOOD DR
Mailing Address - Street 2:
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20816-1361
Mailing Address - Country:US
Mailing Address - Phone:301-320-6885
Mailing Address - Fax:
Practice Address - Street 1:5415 KIRKWOOD DR
Practice Address - Street 2:
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20816-1361
Practice Address - Country:US
Practice Address - Phone:301-320-6885
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD00311402084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry