Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0105X | Surgery of the Hand | 236836 | MA |
NPI | 1962524785 |
---|---|
Provider Name | Jennifer B Green |
First Address | Brighton, MA 02135-2065 |
Second Address | Cambridge, MA 02138-5600 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/04/2007 |
Last Update Date | 07/08/2019 |