| Organization Name: | INFANTS CHILDREN AND YOUTH |
| NPI Number: | 1093776247 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JERRY GREEN (DOCTOR) |
| Mailing Address: | 320 Middletown Blvd The Courtyard Suite 300 Langhorne |
| State: | PA US |
| Postal Code: | 190473204 |
| Phone Number: | 2157520382 |
| Fax Number: | 2157524807 |
| NPI Enumeration Date: | 03/29/2006 |
| NPI Last Update Date: | 07/03/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 174400000X |
| License Number: | OS004790L |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | PA |
| Taxonomy Type: | Other Service Providers |
| Taxonomy Classification: | Specialist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |