Provider Demographics
NPI:1548282361
Name:GREENFIELD, DAVID (PT)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:
Last Name:GREENFIELD
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:40 SCENIC HILLS DR
Mailing Address - Street 2:
Mailing Address - City:POUGHKEEPSIE
Mailing Address - State:NY
Mailing Address - Zip Code:12603-3723
Mailing Address - Country:US
Mailing Address - Phone:845-242-8270
Mailing Address - Fax:845-215-0070
Practice Address - Street 1:1987 STATE ROUTE 52
Practice Address - Street 2:SUITE 11
Practice Address - City:LIBERTY
Practice Address - State:NY
Practice Address - Zip Code:12754-8316
Practice Address - Country:US
Practice Address - Phone:845-292-8580
Practice Address - Fax:845-292-8909
Is Sole Proprietor?:No
Enumeration Date:2006-07-24
Last Update Date:2010-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY010664-12251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYQ10S01Medicare ID - Type Unspecified