Individual
DR. STEPHANIE GREEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
54 MEADOW ST FL 1, NEW HAVEN, CT 06519-1719
(203) 946-8181
Mailing address
54 MEADOW ST FL 1, NEW HAVEN, CT 06519-1719
(203) 946-8181
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
038231
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
010010547CT01
BLUE CROSS
CT
Enumeration date
10/23/2009
Last updated
10/23/2009
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