Doctor Name: | BETTY L GREEN |
NPI Number: | 1174892368 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | RN |
License Number: | 402846-1 |
Business Practice Address: | 278 Route 32 Central Valley, NY - 109173226 |
Business Phone Number: | 8454606200 |
Business Fax Number: | |
Mailing Address: | 156 Pine Tree Rd, MONROE |
State: | NY |
Postal Code: | 109503964 |
Phone Number: | 8454606900 |
Fax Number: | 8454606039 |
NPI Enumeration Date: | 12/19/2011 |
NPI Last Update Date: | 12/19/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 163WS0200X |
License Number: | 402846-1 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
Taxonomy Type: | Nursing Service Providers |
Taxonomy Classification: | Registered Nurse |
Taxonomy Specialization: | School |
Taxonomy Definition: |