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General NPI Number Information
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NPI Number | 1255528865
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Entity Type | Organization
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Legal Business Name | JANET R. GREENE, MD, PC
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Dates
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Enumeration Date | 09/27/2007
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Last Update Date | 10/02/2007
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Provider Practice Location Address
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Address Line | 2019 GALISTEO ST SUITE N4
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City | SANTA FE
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State | NM
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Zip | 87505-2143
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Country | US
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Telephone | 505-982-1910
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Fax | 505-982-1473
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Provider Business Mailing Address
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Address Line | 2019 GALISTEO ST SUITE N4
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City | SANTA FE
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State | NM
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Zip | 87505-2143
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Country | US
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Telephone | 505-982-1910
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Fax | 505-982-1473
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JANET R GREENE
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Credential | MD
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Telephone | 505-982-1910
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 89-139
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License Number State | NM
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