Skip Navigation

Provider Information for 1437620093

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

MS. CRYSTAL NICOLE GREEN RN

Gender: FEMALE

Individual NPI: 1437620093

Calendar   Last Updated:  2018-12-07
  Certification Date: 

Details

Name Value
NPI 1437620093
Enumeration Date 2018-12-07
NPI Type 1 - Individual
Sole Proprietor NO
Status Active
Mailing Address 34 MIDDLE DR
HUNTINGTON, NY 11743-4511
United States

Phone: 631-824-6602 | Fax:
View Map External Link
Primary Practice Address 998 CROOKED HILL RD
BRENTWOOD, NY 11717-1019
United States

Phone: 631-761-2672 | 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 163WP0808X - Registered Nurse Psych/Mental Health NY 6028841