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Provider Information for 1144579152

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

MRS. CHRISTINE V. GREEN

Gender: FEMALE

Individual NPI: 1144579152

Calendar   Last Updated:  2012-09-05
  Certification Date: 

Details

Name Value
NPI 1144579152
Enumeration Date 2012-09-05
NPI Type 1 - Individual
Sole Proprietor YES
Status Active
Mailing Address 160 PINE ST
MASSAPEQUA PARK, NY 11762-1759
United States

Phone: 516-804-5979 | Fax:
View Map External Link
Primary Practice Address 160 PINE ST
MASSAPEQUA PARK, NY 11762-1759
United States

Phone: 516-804-5979 | 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 174400000X - Specialist NY 493399111
No 174400000X - Specialist NY 564041111