Provider Demographics
NPI:1215101647
Name:GREISBERG, SCOTT (PH D)
Entity type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:
Last Name:GREISBERG
Suffix:
Gender:M
Credentials:PH D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 MAMARONECK AVE
Mailing Address - Street 2:411
Mailing Address - City:HARRISON
Mailing Address - State:NY
Mailing Address - Zip Code:10528-1635
Mailing Address - Country:US
Mailing Address - Phone:914-301-9469
Mailing Address - Fax:914-301-9470
Practice Address - Street 1:600 MAMARONECK AVE
Practice Address - Street 2:411
Practice Address - City:HARRISON
Practice Address - State:NY
Practice Address - Zip Code:10528-1635
Practice Address - Country:US
Practice Address - Phone:914-301-9469
Practice Address - Fax:914-301-9470
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-16
Last Update Date:2009-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY016966103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical