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Provider Information for 1700240421

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

CHRISTOPHER RICHARD GREEN

Gender: MALE

Individual NPI: 1700240421

Calendar   Last Updated:  2021-05-26
  Certification Date:  2021-05-26

Details

Name Value
NPI 1700240421
Enumeration Date 2016-04-08
NPI Type 1 - Individual
Sole Proprietor YES
Status Active
Mailing Address 525 E 68TH ST
NEW YORK, NY 10065-4870
United States

Phone: 212-746-4055 | Fax:
View Map External Link
Primary Practice Address 60 E 8TH ST
NEW YORK, NY 10003-6514
United States

Phone: 929-322-4194 | 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 193400000X SINGLE SPECIALTY GROUP
2084P0800X - Psychiatry & Neurology Psychiatry
NY 289821
No 390200000X - Student in an Organized Health Care Education/Training Program