Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207KA0200X | Allergist | 124074-2 | NY |
NPI | 1427050301 |
---|---|
Provider Name | Dr. Andrew Wolfe Green |
First Address | Williamsville, NY 14221-5782 |
Second Address | Orchard Park, NY 14127-1842 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/08/2005 |
Last Update Date | 21/06/2019 |