Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207KA0200X | Allergist | MD007302E | PA |
NPI | 1154316594 |
---|---|
Provider Name | Dr. George R Green |
First Address | Abington, PA 19001-3800 |
Second Address | Abington, PA 19001-3800 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/09/2005 |
Last Update Date | 01/06/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
D71039 | (02) | PA |