Individual
DR. JERRY A. GREEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
67 AUNT HACK RD, DANBURY, CT 06811-2720
(203) 798-6566
(203) 790-5883
Mailing address
67 AUNT HACK RD, DANBURY, CT 06811-2720
(203) 798-6566
(203) 790-5883
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
023599
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001235993
—
CT
Enumeration date
01/10/2006
Last updated
04/09/2020
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