Individual
ALICIA GREEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5050 ISELIN AVE, BRONX, NY 10471-2915
(718) 549-6700
Mailing address
20 ROLLINS ST, APT 2E, YONKERS, NY 10705-4362
(718) 450-7716
Taxonomy
Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
—
—
Other
Enumeration date
11/10/2011
Last updated
11/10/2011
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