Provider Demographics
NPI:1871615609
Name:GREENE, ROSEMARIE GAMBALE (ROSEMARIE GREENE)
Entity type:Individual
Prefix:MS
First Name:ROSEMARIE
Middle Name:GAMBALE
Last Name:GREENE
Suffix:
Gender:F
Credentials:ROSEMARIE GREENE
Other - Prefix:MS
Other - First Name:ROSEMARIE
Other - Middle Name:G
Other - Last Name:GREENE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:ROSEMARIE GREENE
Mailing Address - Street 1:70 E 10TH ST
Mailing Address - Street 2:APT 11U
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10003-5102
Mailing Address - Country:US
Mailing Address - Phone:212-473-8283
Mailing Address - Fax:
Practice Address - Street 1:80 E 11TH ST
Practice Address - Street 2:ROOM 434
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10003-6811
Practice Address - Country:US
Practice Address - Phone:917-886-0953
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR054655-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical