Provider Demographics
NPI:1194146779
Name:GREENSTEIN, MORDICAI A-E (DPT)
Entity type:Individual
Prefix:MR
First Name:MORDICAI
Middle Name:A-E
Last Name:GREENSTEIN
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:48 BAKERTOWN RD.
Mailing Address - Street 2:SUITE 401
Mailing Address - City:MONROE
Mailing Address - State:NY
Mailing Address - Zip Code:10950
Mailing Address - Country:US
Mailing Address - Phone:845-782-2300
Mailing Address - Fax:845-782-4176
Practice Address - Street 1:1 DINEV RD-
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:NY
Practice Address - Zip Code:10950
Practice Address - Country:US
Practice Address - Phone:845-782-7510
Practice Address - Fax:845-782-5849
Is Sole Proprietor?:No
Enumeration Date:2013-12-26
Last Update Date:2013-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY037148225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist