Individual
DR. JOSEPH A. GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
1513 SCALP AVE, SUITE 280, JOHNSTOWN, PA 15904-3331
(814) 266-7611
(814) 266-3532
Mailing address
1513 SCALP AVE, SUITE 280, JOHNSTOWN, PA 15904-3331
(814) 266-7611
(814) 266-3532
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OEG 000189
PA
152WC0802X
Corneal and Contact Management Optometrist
OEG 000189
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0014035280001
—
PA
Enumeration date
02/10/2006
Last updated
11/30/2007
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