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Provider Information for 1962974345

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

CHIANNE GREEN

Gender: FEMALE

Individual NPI: 1962974345

Calendar   Last Updated:  2021-03-05
  Certification Date:  2021-03-05

Details

Name Value
NPI 1962974345
Enumeration Date 2018-12-22
NPI Type 1 - Individual
Sole Proprietor YES
Status Active
Mailing Address 165 CLINTON AVE APT 2E
BROOKLYN, NY 11205-3502
United States

Phone: 718-488-7197 | Fax:
View Map External Link
Primary Practice Address 159 20TH ST
BROOKLYN, NY 11232-1253
United States

Phone: 646-685-4422 | 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
104100000X - Social Worker
NY 099983