Individual
ARRY L GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA
Contact information
Practice address
359 GRIDER ST, BUFFALO, NY 14215-3016
(716) 895-7715
(716) 893-1692
Mailing address
525 WASHINGTON ST, BUFFALO, NY 14203-1711
(716) 856-4494
(716) 842-1277
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00030241501
UNIVERA
NY
01
—
000506354005
COMMUNITY BLUE
—
Enumeration date
02/12/2007
Last updated
07/08/2007
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