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Provider Information for 1609135573

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

DR. DANIEL A GREEN M.D.

Gender: MALE

Individual NPI: 1609135573

Calendar   Last Updated:  2019-10-23
  Certification Date: 

Details

Name Value
NPI 1609135573
Enumeration Date 2012-05-11
NPI Type 1 - Individual
Sole Proprietor NO
Status Active
Mailing Address 622 W 168TH ST DEPT OF
NEW YORK, NY 10032-3720
United States

Phone: | Fax:
View Map External Link
Primary Practice Address 622 W 168TH ST DEPT OF
NEW YORK, NY 10032-3720
United States

Phone: 212-305-6301 | 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 207ZP0105X - Pathology Clinical Pathology/Laboratory Medicine NY 278305