Individual
DR. JEREMY GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
506 6TH ST, BROOKLYN, NY 11215-3609
(718) 780-5870
(718) 780-7719
Mailing address
34 W 12TH ST, APT. 4FR, NEW YORK, NY 10011-8636
(917) 406-0283
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
218026
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02639421
—
NY
Enumeration date
07/24/2006
Last updated
05/28/2010
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