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General NPI Number Information
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NPI Number | 1811989361
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Entity Type | Individual
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Provider Name | JENNIFER A GREEN M.D.
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Gender | Female
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Dates
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Enumeration Date | 08/19/2005
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 2123 AUBURN AVE 528
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City | CINCINNATI
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State | OH
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Zip | 45219-2906
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Country | US
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Telephone | 513-792-5800
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Fax | 513-792-5806
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Provider Business Mailing Address
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Address Line | 157 LINDEN DR
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City | WYOMING
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State | OH
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Zip | 45215-4204
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Country | US
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Telephone |
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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 | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 35075307
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License Number State | OH
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