Individual
CARINE CORTRELL GREEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
X
Contact information
Practice address
4238 MERRICK RD, MASSAPEQUA, NY 11758-6016
(631) 690-5155
Mailing address
33 COUNTRY GREENS DR, HOLTSVILLE, NY 11742-1033
(929) 339-8963
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
349350
NY
Other
Enumeration date
01/17/2025
Last updated
01/17/2025
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