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Individual

ILEANA GREEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
5 PERRYRIDGE RD, PATHOLOGY DEPT., GREENWICH, CT 06830
(203) 863-3061
(203) 863-3846
Mailing address
99 EAST RIVER DR., 5TH FLOOR, EAST HARTFORD, CT 06108-7301
(860) 282-4133
(860) 282-0170

Taxonomy

Speciality
Code
Description
License number
State
207ZP0101X
Anatomic Pathology Physician
203054
NY
207ZP0101X
Anatomic Pathology Physician
Primary
52497
CT

Other

Enumeration date
02/03/2006
Last updated
06/30/2014
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