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General NPI Number Information
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NPI Number | 1225474604
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Entity Type | Individual
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Provider Name | HYERYONG CHO GREEN ANP-C
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Gender | Female
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Dates
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Enumeration Date | 05/13/2013
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Last Update Date | 05/13/2013
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Provider Practice Location Address
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Address Line | 301 E 17TH ST
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City | NEW YORK
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State | NY
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Zip | 10003-3804
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Country | US
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Telephone | 212-598-6000
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Fax |
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Provider Business Mailing Address
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Address Line | 29 PALMER PL
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City | LEONIA
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State | NJ
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Zip | 07605-1314
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Country | US
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Telephone | 917-414-3003
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | F306168
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License Number State | NY
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