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Provider Information for 1972765253

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. BRAD GREEN MD

Gender: MALE

Individual NPI: 1972765253

Calendar   Last Updated:  2020-01-31
  Certification Date:  2020-01-31

Details

Name Value
NPI 1972765253
Enumeration Date 2008-06-27
NPI Type 1 - Individual
Sole Proprietor NO
Status Active
Mailing Address 6835 E CAMELBACK RD UNIT 5005
SCOTTSDALE, AZ 85251-3156
United States

Phone: 571-338-1966 | Fax:
View Map External Link
Primary Practice Address 126 W 82ND ST APT 1
NEW YORK, NY 10024-5584
United States

Phone: 571-338-1966 | 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 207P00000X - Emergency Medicine OH 35.124189
No 207P00000X - Emergency Medicine NM MD2020-0058