Individual
DANIEL ROBERT GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
212 HIGHBRIDGE ST, SUITE A, FAYETTEVILLE, NY 13066-1981
(315) 637-9116
Mailing address
212 HIGHBRIDGE ST, SUITE A, FAYETTEVILLE, NY 13066-1981
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
09/18/2014
Last updated
09/18/2014
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