Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0201X | Pediatric Allergist | MD428548 | PA |
NPI | 1770527574 |
---|---|
Provider Name | Todd Green |
First Address | Pittsburgh, PA 15213-2536 |
Second Address | Pittsburgh, PA 15213-3320 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/06/2006 |
Last Update Date | 24/05/2021 |