Organization
GREEN PODIATRY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WILLIAM J GREEN DPM (OWNER)
(609) 217-8905
Entity
Organization
Contact information
Practice address
111 MAPLE GROVE BLVD, LUMBERTON, NJ 08048-4617
(609) 217-8905
Mailing address
111 MAPLE GROVE BLVD, LUMBERTON, NJ 08048-4617
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
25MD00214300
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1094025
UNITED HEALTHCARE
—
01
—
1725652
CIGNA
—
05
—
5486904
—
NJ
01
—
P3800567
OXFORD
—
Enumeration date
04/21/2013
Last updated
04/21/2013
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