Individual
MRS. SUSAN B GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD, MPH, CDN
Contact information
Practice address
6846 BUCKLEY RD, N SYRACUSE, NY 13212-4275
(315) 410-6400
Mailing address
6846 BUCKLEY ROAD, N. SYRACUSE, NY 13212
(315) 410-6400
Taxonomy
Speciality
Code
Description
License number
State
133VN1005X
Renal Nutrition Registered Dietitian
Primary
391052
NY
Other
Enumeration date
08/28/2009
Last updated
08/28/2009
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