| Doctor Name: | DR. SCOTT A GREEN |
| NPI Number: | 1003813502 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | D.O. |
| License Number: | 000346 |
| Business Practice Address: | 35 Kennedy Dr Putnam, CT - 062601939 |
| Business Phone Number: | 8609632133 |
| Business Fax Number: | 8609638955 |
| Mailing Address: | 35 Kennedy Dr, PUTNAM |
| State: | CT |
| Postal Code: | 062601939 |
| Phone Number: | 8609632133 |
| Fax Number: | 8609638955 |
| NPI Enumeration Date: | 06/30/2005 |
| NPI Last Update Date: | 09/03/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 204C00000X |
| License Number: | 000346 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CT |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Neuromusculoskeletal Medicine, Sports Medicine |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |