Individual
DR. NATHANIEL GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
5501 OLD YORK RD., LEVY BUILDING, 2F C/O CORETTA PHILGENCE, PHILADELPHIA, PA 19141
(215) 456-7595
Mailing address
PO BOX 270, EMPORIUM, PA 15834-0270
(202) 468-8804
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
MT217003
PA
Other
Enumeration date
07/09/2018
Last updated
07/01/2021
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