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Provider Information for 1003050501

Please Note: Issuance of an NPI does not ensure or validate that the Health Care Provider is Licensed or Credentialed. For more information please refer to NPI: What You Need to Know

CASSIE LAUREN GREEN M.S., CCC-SLP

Gender: FEMALE

Individual NPI: 1003050501

Calendar   Last Updated:  2009-04-28
  Certification Date: 

Details

Name Value
NPI 1003050501
Enumeration Date 2009-04-28
NPI Type 1 - Individual
Sole Proprietor YES
Status Active
Mailing Address 4 ELIOT CT
TEANECK, NJ 07666-6468
United States

Phone: 201-281-3781 | Fax:
View Map External Link
Primary Practice Address 1650 GRAND CONCOURSE
BRONX, NY 10457-7606
United States

Phone: 201-281-3781 | Fax:
View Map External Link
Health Information Exchange
Endpoint Type Endpoint Endpoint Description Use Content Type Affiliation Endpoint Location
Other Identifiers
Issuer State Number
Taxonomy
Primary Taxonomy Selected Taxonomy State License Number
Yes 235Z00000X - Speech-Language Pathologist NY 018945-1