Active NPI
Daniel Greenblatt, MD
- Pediatric Neurodevelopmental Disabilities Physician
- Latham, NY
National Provider Identifier
1962638965
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Neurodevelopmental Disabilities Physician
- License
- 240471
- Practice address
- 7B Johnson Rd
Latham, NY 12110-3003 - Phone
- (518) 782-7733
- Fax
- (518) 782-0800
- NPI assigned
- Jun 4, 2009
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Pediatric Neurodevelopmental Disabilities Physician | 2080P0008X | 240471 | NY | Primary |
Addresses
Primary practice location
7B Johnson Rd
Latham, NY 12110-3003
Mailing address
711 Troy Schenectady Rd Ste 203
Latham, NY 12110-2461
Phone (518) 782-3700
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 9735601 | Other | NY | AETNA |
| 03240411 | Medicaid | NY | |
| 312DU1 | Other | NY | EMPIRE BC |
| 120927000094 | Other | NY | FIDELIS CARE NY |
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
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 240471 | NY | MD | Pediatric Neurodevelopmental Disabilities Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1244073600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1516233600000",
"number": "1962638965",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "711 TROY SCHENECTADY RD STE 203",
"city": "LATHAM",
"state": "NY",
"postal_code": "121102461",
"telephone_number": "518-782-3700",
"fax_number": "518-782-3799"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7B JOHNSON RD",
"city": "LATHAM",
"state": "NY",
"postal_code": "121103003",
"telephone_number": "518-782-7733",
"fax_number": "518-782-0800"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GREENBLATT",
"first_name": "DANIEL",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2009-06-04",
"last_updated": "2018-01-18",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "2080P0008X",
"taxonomy_group": "",
"desc": "Pediatrics, Neurodevelopmental Disabilities",
"state": "NY",
"license": "240471",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "9735601",
"state": "NY"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "03240411",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "EMPIRE BC",
"identifier": "312DU1",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FIDELIS CARE NY",
"identifier": "120927000094",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Latham, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.