Healthcare Provider Details

I. General information

NPI: 1447246889
Provider Name (Legal Business Name): GREEN-WOOD ASSOCIATES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/21/2005
Last Update Date: 11/14/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

930 CHURCH ST
PLEASANTVILLE NJ
08232-4271
US

IV. Provider business mailing address

409 STENTON AVE # 30
FLOURTOWN PA
19031-1327
US

V. Phone/Fax

Practice location:
  • Phone: 609-646-6900
  • Fax: 609-645-3799
Mailing address:
  • Phone: 610-832-8000
  • Fax: 610-832-8111

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License NumberNJS262H
License Number StateNJ

VIII. Authorized Official

Name: MRS. ANDREA NATICCHIONE
Title or Position: MANAGING PARTNER
Credential:
Phone: 610-832-8000