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Provider Information for 1912597626

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

ASHLEY TAYLOR GREEN

Gender: FEMALE

Individual NPI: 1912597626

Calendar   Last Updated:  2021-05-11
  Certification Date:  2021-05-11

Details

Name Value
NPI 1912597626
Enumeration Date 2021-01-26
NPI Type 1 - Individual
Sole Proprietor YES
Status Active
Mailing Address 45 MAPLE AVE
BALLSTON SPA, NY 12020-1015
United States

Phone: | Fax:
View Map External Link
Primary Practice Address ADVANCED THERAPY 10B MADISON AVE EXTENSION
ALBANY, NY 12203
United States

Phone: 518-867-3061 | 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 224Z00000X - Occupational Therapy Assistant NY 010687-01
No 224Z00000X - Occupational Therapy Assistant