Individual
DIANE GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
9131 QUEENS BVLD, NEW YORK, NY 11373-9997
(718) 779-7000
(718) 697-6167
Mailing address
91 31 QUEENS BLVD, ELMHURST, NY 11373-9997
(718) 779-7000
(718) 697-6167
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
F35236701
NY
Other
Enumeration date
05/06/2015
Last updated
08/02/2023
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