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Provider Information for 1881707388

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. CORI GREEN MD

Gender: FEMALE

Individual NPI: 1881707388

Calendar   Last Updated:  2018-12-18
  Certification Date: 

Details

Name Value
NPI 1881707388
Enumeration Date 2006-08-17
NPI Type 1 - Individual
Sole Proprietor NO
Status Active
Mailing Address 525 E 68TH ST # 139
NEW YORK, NY 10065-4870
United States

Phone: 212-746-0921 | Fax:
View Map External Link
Primary Practice Address 525 E 68TH ST # 139
NEW YORK, NY 10065-4870
United States

Phone: 212-746-0921 | Fax:
View Map External Link
Health Information Exchange
Endpoint Type Endpoint Endpoint Description Use Content Type Affiliation Endpoint Location
Other Identifiers
Issuer State Number
MEDICAID NY 131623978
Taxonomy
Primary Taxonomy Selected Taxonomy State License Number
Yes 208000000X - Pediatrics NY 240316