Individual
DR. JON DAVID GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
449 MOUNT PLEASANT AVE, 2ND FLOOR, WEST ORANGE, NJ 07052-2723
(973) 731-7868
(973) 731-7907
Mailing address
PO BOX 416457, BOSTON, MA 02241-6457
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
MA03035500
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1948709
—
NJ
Enumeration date
05/18/2006
Last updated
11/21/2016
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