Marissa Tracy Greenberg, CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

14317721 Issued in NY

Practice address

1070 E 104TH St
Brooklyn, NY 11236-4526

Phone

(718) 444-4316

NPI assigned

Apr 24, 2017

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Marissa Tracy Lederman Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1492992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562630400000",
    "number": "1851826200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1070 E 104TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112364526"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1070 E 104TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112364526",
            "telephone_number": "718-444-4316"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "43 Georgetown Ln",
            "address_purpose": "LOCATION",
            "city": "Brooklyn",
            "state": "NY",
            "postal_code": "112345741",
            "country_code": "US",
            "telephone_number": "917-599-7617",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GREENBERG",
        "first_name": "MARISSA",
        "middle_name": "TRACY",
        "credential": "CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-04-24",
        "last_updated": "2019-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "14317721",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARISSA",
            "last_name": "LEDERMAN",
            "middle_name": "TRACY",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Kalman Kenneth Greenberg, LMHC
• Linda E Greenberg, MS,RD,CDN
• Lisa Greenberg
• Lisa B. Greenberg, M.S. CCC-SLP
• Marcy Greenberg
• Martin Greenberg
• Max Greenberg
• Mendel Greenberg
• Miriam Celia Greenberg, MD
• Myron Greenberg

• Speech-Language Pathologist in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• Speech-Language Pathologist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.