Provider Demographics
NPI:1679709588
Name:BRANDT-GREENFELD, RACHEL (PHD)
Entity type:Individual
Prefix:DR
First Name:RACHEL
Middle Name:
Last Name:BRANDT-GREENFELD
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 WASHINGTON PL
Mailing Address - Street 2:3RD FLOOR-NDTC
Mailing Address - City:NEWARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07102-3127
Mailing Address - Country:US
Mailing Address - Phone:973-645-3042
Mailing Address - Fax:973-622-4813
Practice Address - Street 1:20 WASHINGTON PL
Practice Address - Street 2:3RD FLOOR-NDTC
Practice Address - City:NEWARK
Practice Address - State:NJ
Practice Address - Zip Code:07102-3127
Practice Address - Country:US
Practice Address - Phone:973-645-3042
Practice Address - Fax:973-622-4813
Is Sole Proprietor?:No
Enumeration Date:2009-06-05
Last Update Date:2010-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ35S100465700103T00000X
NY017736103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist