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NPI Code Detail

MEDICARE: PAULETTE GREEN

MEDICARE: PAULETTE GREEN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225200000XPhysical Therapy Assistant

General Provider Information

NPI Number : 1457214900
Entity Type Code : Individual
Provider Name (Legal Business Name) : PAULETTE GREEN
Provider Business Mailing Address
First Line : 1311 MAMARONECK AVE STE 140
Second Line :
City : WHITE PLAINS
State : NY
Zip : 10605-5224
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 23204 COLUMBUS RD
Second Line :
City : COLUMBUS
State : NJ
Zip : 08022-1904
Country : US
Telephone Number : 609-324-1200
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/03/2025
Last Update Date : 12/03/2025

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Directions to “ PAULETTE GREEN ” Practice Location

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