Provider Demographics
NPI:1447997937
Name:GREENWALD, MICHELLE BUTTERFASS (PHD)
Entity type:Individual
Prefix:DR
First Name:MICHELLE
Middle Name:BUTTERFASS
Last Name:GREENWALD
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 WINDSOR RD
Mailing Address - Street 2:
Mailing Address - City:HASTINGS ON HUDSON
Mailing Address - State:NY
Mailing Address - Zip Code:10706-3010
Mailing Address - Country:US
Mailing Address - Phone:917-744-9620
Mailing Address - Fax:
Practice Address - Street 1:25 WINDSOR RD
Practice Address - Street 2:
Practice Address - City:HASTINGS ON HUDSON
Practice Address - State:NY
Practice Address - Zip Code:10706-3010
Practice Address - Country:US
Practice Address - Phone:917-744-9620
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-16
Last Update Date:2022-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY016375-1103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist