Individual
DR. JESSE ANDREW GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
51 NORTH 39TH STREET, PHILADELPHIA, PA 19104
(215) 662-8900
(518) 262-6470
Mailing address
51 NORTH 39TH STREET, 218 WRIGHT SAUNDERS, PHILADELPHIA, PA 19104
(215) 662-8900
(518) 262-6470
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
MD450077
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01460562
—
NY
Enumeration date
08/16/2005
Last updated
05/07/2014
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