Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103G00000X | Clinical Psychologist | 9866 | NY |
Y | 103TC0700X | Clinical Psychologist | 9866 | NY |
NPI | 1003973322 |
---|---|
Provider Name | Karen Julie Greene |
First Address | Orangeburg, NY 10962-0566 |
Second Address | New York, NY 10024-6480 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/01/2007 |
Last Update Date | 03/09/2010 |