Individual
ELIZABETH MARIE GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
51 N 39TH ST, PHILADELPHIA, PA 19104-2640
(215) 662-8000
Mailing address
51 N 39TH ST, PHILADELPHIA, PA 19104-2640
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
MA065219
PA
Other
Enumeration date
11/13/2023
Last updated
03/29/2024
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