Individual
BRENDA DODD-GREEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
260 E 188TH ST, BRONX, NY 10458-5302
(718) 960-3399
(718) 960-6290
Mailing address
260 E 188TH ST, BRONX, NY 10458-5302
(718) 960-3399
(718) 960-6290
Taxonomy
Speciality
Code
Description
License number
State
174H00000X
Health Educator
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02064111
—
NY
Enumeration date
03/02/2020
Last updated
03/02/2020
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