Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RR0500X | Rheumatology | 144291 | NY |
NPI | 1043220825 |
---|---|
Provider Name | Dr. Stuart Green |
First Address | Brooklyn, NY 11201-5425 |
Second Address | Brooklyn, NY 11201-5425 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/08/2006 |
Last Update Date | 06/06/2008 |