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Provider Information for 1396153037

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

AYANA JANELLE GREEN

Gender: FEMALE

Individual NPI: 1396153037

Calendar   Last Updated:  2014-07-25
  Certification Date: 

Details

Name Value
NPI 1396153037
Enumeration Date 2014-07-25
NPI Type 1 - Individual
Sole Proprietor YES
Status Active
Mailing Address 544 E MAIN ST APT 72
MIDDLETOWN, NY 10940-2691
United States

Phone: 646-765-2251 | Fax: 845-381-1241
View Map External Link
Primary Practice Address 544 E MAIN ST APT 72
MIDDLETOWN, NY 10940-2691
United States

Phone: 646-765-2251 | Fax: 845-381-1241
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 172V00000X - Community Health Worker