Individual
CASONYA T GREEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CDE
Contact information
Practice address
311 W 43RD ST, NEW YORK, NY 10036
(404) 590-7533
Mailing address
311 W 43RD ST, NEW YORK, NY 10036-6413
(404) 590-7533
Taxonomy
Speciality
Code
Description
License number
State
174H00000X
Health Educator
Primary
14328
GA
Other
Enumeration date
08/06/2019
Last updated
09/04/2019
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