Individual
JOHN GREEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
100 PARK ST, GLENS FALLS, NY 12801-4413
(518) 926-6161
Mailing address
10652 STATE ROUTE 149, FORT ANN, NY 12827-1906
(518) 791-8941
Taxonomy
Speciality
Code
Description
License number
State
282N00000X
General Acute Care Hospital
Primary
694511
NY
Other
Enumeration date
07/04/2016
Last updated
07/04/2016
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