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Provider Information for 1902092067

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. ALAN S GREEN M.D.

Gender: MALE

Individual NPI: 1902092067

Calendar   Last Updated:  2007-09-21
  Certification Date: 

Details

Name Value
NPI 1902092067
Enumeration Date 2007-09-21
NPI Type 1 - Individual
Sole Proprietor YES
Status Active
Mailing Address 2805 202ND ST
BAYSIDE, NY 11360-2326
United States

Phone: 212-267-4177 | Fax: 212-233-8525
View Map External Link
Primary Practice Address 2805 202ND ST
BAYSIDE, NY 11360-2326
United States

Phone: 212-267-4177 | Fax: 212-233-8525
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 207Q00000X - Family Medicine NY 142883