Provider Demographics
NPI:1912169244
Name:GREENBERG, NAOMI R
Entity type:Individual
Prefix:MS
First Name:NAOMI
Middle Name:R
Last Name:GREENBERG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5506 BRYANT ST
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15206-1429
Mailing Address - Country:US
Mailing Address - Phone:412-400-3151
Mailing Address - Fax:
Practice Address - Street 1:801 N NEGLEY AVE
Practice Address - Street 2:SUITE 7
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15206-1560
Practice Address - Country:US
Practice Address - Phone:412-400-3151
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-27
Last Update Date:2009-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW124397104100000X
PACW0160421041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA2063504OtherHIGHMARK
PA102206482Medicaid
PA2063504OtherHIGHMARK