Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TC1900X | Counseling Psychologist | NYS012377 | NY |
NPI | 1114139912 |
---|---|
Provider Name | Dr. David Eastman Greenan |
First Address | New York, NY 10011-7200 |
Second Address | New York, NY 10011-7200 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/05/2007 |
Last Update Date | 08/07/2007 |