Individual provider Active NPI

Lyle Edward Greenman, PH.D.

  • Psychologist
  • Roslyn Heights, NY
National Provider Identifier
1255542056
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
5335 Issued in NY
Practice address
2 Sycamore LN
Roslyn Heights, NY 11577-2522
Phone
(516) 621-0356
Fax
(516) 626-3194
NPI assigned
May 24, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 5335 NY Primary

Addresses

Primary practice location

2 Sycamore LN
Roslyn Heights, NY 11577-2522

Mailing address

2 Sycamore LN
Roslyn Heights, NY 11577-2522
Phone (516) 621-0356

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120306000613 NY Practitioner - Clinical Psychologist 6204095516 Practice locations: Roslyn Heights, NY

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1976
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2 Sycamore LN
Roslyn Heights, NY 11577-2522
Phone 51662103561

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
5335NYMDPsychologist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1179964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1255542056",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 SYCAMORE LN",
            "city": "ROSLYN HEIGHTS",
            "state": "NY",
            "postal_code": "115772522",
            "telephone_number": "516-621-0356",
            "fax_number": "516-626-3194"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 SYCAMORE LN",
            "city": "ROSLYN HEIGHTS",
            "state": "NY",
            "postal_code": "115772522",
            "telephone_number": "516-621-0356",
            "fax_number": "516-626-3194"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREENMAN",
        "first_name": "LYLE",
        "middle_name": "EDWARD",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-24",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NY",
            "license": "5335",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roslyn Heights, NY

Sources for this page

Verify at the official NPI Registry.