Active NPI
Kenneth S Greenwald, LCSW
- Psychoanalyst
- New York, NY
National Provider Identifier
1740495266
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychoanalyst
- License
- R071074-1
- Practice address
- 336 W End Ave
Suite 19a
New York, NY 10023-8116 - Phone
- (212) 724-5510
- Fax
- (212) 724-5510
- NPI assigned
- May 10, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychoanalyst | 102L00000X | R071074-1 | NY | Primary |
Addresses
Primary practice location
336 W End Ave
Suite 19a
New York, NY 10023-8116
Mailing address
336 W End Ave
Suite 19a
New York, NY 10023-8116
Phone (212) 724-5510
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| R071074-1 | Other | NY | NEW YORK STATE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R071074-1 | NY | MD | Psychoanalyst |
| 059326 | NY | MD | Pharmacist |
| 071074 | NY | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1178755200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1255996800000",
"number": "1740495266",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "336 W END AVE",
"address_2": "SUITE 19A",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100238116",
"telephone_number": "212-724-5510",
"fax_number": "212-724-5510"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "336 W END AVE",
"address_2": "SUITE 19A",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100238116",
"telephone_number": "212-724-5510",
"fax_number": "212-724-5510"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GREENWALD",
"first_name": "KENNETH",
"middle_name": "S",
"name_prefix": "Mr.",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-05-10",
"last_updated": "2009-10-20",
"status": "A"
},
"taxonomies": [
{
"code": "102L00000X",
"taxonomy_group": "",
"desc": "Psychoanalyst",
"state": "NY",
"license": "R071074-1",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NEW YORK STATE",
"identifier": "R071074-1",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}
Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.