Provider Demographics
NPI:1144195967
Name:GREENLEAF PSYCHIATRY
Entity type:Organization
Organization Name:GREENLEAF PSYCHIATRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:SANDIP
Authorized Official - Middle Name:
Authorized Official - Last Name:KHATRI
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:646-255-0316
Mailing Address - Street 1:1698 POST RD E STE 2A
Mailing Address - Street 2:
Mailing Address - City:WESTPORT
Mailing Address - State:CT
Mailing Address - Zip Code:06880-5652
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1698 POST RD E STE 2A
Practice Address - Street 2:
Practice Address - City:WESTPORT
Practice Address - State:CT
Practice Address - Zip Code:06880-5652
Practice Address - Country:US
Practice Address - Phone:203-872-5839
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-10-09
Last Update Date:2025-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health