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Provider Information for 1073583209

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

ADINA SIMONE GREEN DMD

Other Name:   ADINA SIMONE
Gender: FEMALE

Individual NPI: 1073583209

Calendar   Last Updated:  2007-07-08
  Certification Date: 

Details

Name Value
NPI 1073583209
Enumeration Date 2006-01-23
NPI Type 1 - Individual
Sole Proprietor NO
Status Active
Mailing Address 2001 MARCUS AVE STE 168 S
LAKE SUCCESS, NY 11042
United States

Phone: 516-775-2004 | Fax: 516-829-7987
View Map External Link
Primary Practice Address 2001 MARCUS AVE STE 168 S
LAKE SUCCESS, NY 11042
United States

Phone: 516-775-2004 | Fax: 516-829-7987
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 122300000X - Dentist NY 041955