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Individual
MR. ELLIOT GREEN
Active
Individual
MR. ELLIOT GREEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
REGISTERED NURSE
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
608511-1
NY
Other
Enumeration date
12/14/2017
Last updated
12/14/2017
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