Organization
INFANTS CHILDREN AND YOUTH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JERRY GREEN D.O. (DOCTOR)
(215) 752-0382
Entity
Organization
Contact information
Practice address
320 MIDDLETOWN BLVD, THE COURTYARD SUITE 300, LANGHORNE, PA 19047-3204
(215) 752-0382
(215) 752-4807
Mailing address
320 MIDDLETOWN BLVD, THE COURTYARD SUITE 300, LANGHORNE, PA 19047-3204
(215) 752-0382
(215) 752-4807
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
MD032401E
PA
174400000X
Specialist
Primary
OS003032L
PA
174400000X
Specialist
OS004790L
PA
Other
Enumeration date
03/29/2006
Last updated
07/03/2008
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