Individual
DEANDRA GREEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
75-59 263RD ST, GLEN OAKS, NY 11004
(718) 470-8100
Mailing address
75-59 263RD ST, GLEN OAKS, NY 11004-4909
(516) 547-2509
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
F357105-01
NY
Other
Enumeration date
07/21/2025
Last updated
07/21/2025
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