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NPI Code Detail

MEDICARE: MS. CHARLOTTE S. GREENE PA

MEDICARE: MS. CHARLOTTE S. GREENE PA
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
1363AM0700XMedical Physician AssistantPA1549ME

General Provider Information

NPI Number : 1740280031
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. CHARLOTTE S. GREENE PA
Provider Business Mailing Address
First Line : 15 HOSPITAL DR
Second Line : THEBAUD BUILDING, FOURTH FLOOR
City : YORK
State : ME
Zip : 03909-1011
Country : US
Telephone Number : 973-267-2293
Fax Number : 973-267-3144
Provider Business Practice Location Address
First Line : 15 HOSPITAL DR
Second Line :
City : YORK
State : ME
Zip : 03909-1011
Country : US
Telephone Number : 207-351-2478
Fax Number : 207-351-2216
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/28/2005
Last Update Date : 03/31/2016

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Directions to “ MS. CHARLOTTE S. GREENE PA” Practice Location

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