Provider Demographics
NPI:1588340111
Name:GREENBERG, KAITLYN (ATC)
Entity type:Individual
Prefix:
First Name:KAITLYN
Middle Name:
Last Name:GREENBERG
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:475 UNION SCHOOL RD
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:NY
Mailing Address - Zip Code:10941-5008
Mailing Address - Country:US
Mailing Address - Phone:845-649-4323
Mailing Address - Fax:
Practice Address - Street 1:475 UNION SCHOOL RD
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:NY
Practice Address - Zip Code:10941-5008
Practice Address - Country:US
Practice Address - Phone:845-649-4323
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-27
Last Update Date:2023-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer