1629125588 NPI number — MS. ANN TOBY GREENE ACSW LCSW

Table of content: MS. ANN TOBY GREENE ACSW LCSW (NPI 1629125588)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1629125588 NPI number — MS. ANN TOBY GREENE ACSW LCSW

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
GREENE
Provider First Name:
ANN
Provider Middle Name:
TOBY
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
ACSW LCSW
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
GONZALEZ
Provider Other First Name:
ANN
Provider Other Middle Name:
TOBY
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1629125588
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
157 DOGWOOD ROAD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CORTLANDT MANOR
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
10567
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
914-736-2250
Provider Business Mailing Address Fax Number:
914-736-2250

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
925 CENTRAL AVENUE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PEEKSKILL
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10566
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
914-659-7971
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
01/04/2007

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1041C0700X , with the licence number:  R0193191 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)