Individual
MRS. CHRISTINE V. GREEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
160 PINE ST, MASSAPEQUA PARK, NY 11762-1759
(516) 804-5979
Mailing address
160 PINE ST, MASSAPEQUA PARK, NY 11762-1759
(516) 804-5979
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
493399111
NY
174400000X
Specialist
564041111
NY
Other
Enumeration date
09/05/2012
Last updated
09/05/2012
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