Individual
DR. BENJAMIN GREENE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
6 GREENWICH OFFICE PARK, GREENWICH, CT 06831-5151
(203) 869-1145
Mailing address
3959 BROADWAY, NEW YORK, NY 10032-1559
Taxonomy
Speciality
Code
Description
License number
State
2080S0010X
Pediatric Sports Medicine Physician
301291
NY
2080S0010X
Pediatric Sports Medicine Physician
Primary
FG8950621
CT
390200000X
Student in an Organized Health Care Education/Training Program
—
NY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/21/2017
Last updated
11/18/2021
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