Provider Demographics
NPI:1114355153
Name:GREENSPAN, RIVKA (MSED)
Entity type:Individual
Prefix:MISS
First Name:RIVKA
Middle Name:
Last Name:GREENSPAN
Suffix:
Gender:F
Credentials:MSED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1320 54TH ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11219-4219
Mailing Address - Country:US
Mailing Address - Phone:718-303-9400
Mailing Address - Fax:718-303-9494
Practice Address - Street 1:1320 54TH ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11219-4219
Practice Address - Country:US
Practice Address - Phone:718-303-9400
Practice Address - Fax:718-303-9494
Is Sole Proprietor?:Yes
Enumeration Date:2013-10-30
Last Update Date:2013-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist