| Doctor Name: | MRS. KRISTEN M GREEN |
| NPI Number: | 1093891145 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PA, RPT |
| License Number: | 005277 |
| Business Practice Address: | 102 Marble River Rd Chateaugay, NY - 129203600 |
| Business Phone Number: | 5183536120 |
| Business Fax Number: | |
| Mailing Address: | 102 Marble River Rd, CHATEAUGAY |
| State: | NY |
| Postal Code: | 129203600 |
| Phone Number: | 5183536120 |
| Fax Number: | |
| NPI Enumeration Date: | 10/31/2006 |
| NPI Last Update Date: | 01/03/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AM0700X |
| License Number: | 005277 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | NY |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Medical |
| Taxonomy Definition: | |