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General NPI Number Information
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NPI Number | 1962524785
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Entity Type | Individual
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Provider Name | JENNIFER B GREEN MD
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Gender | Female
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Dates
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Enumeration Date | 04/04/2007
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Last Update Date | 08/07/2019
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Provider Practice Location Address
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Address Line | 300 MOUNT AUBURN ST SUTIE 505
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City | CAMBRIDGE
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State | MA
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Zip | 02138-5600
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Country | US
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Telephone | 617-491-6766
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Fax | 617-491-2552
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Provider Business Mailing Address
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Address Line | 20 GUEST ST STE 225
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City | BRIGHTON
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State | MA
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Zip | 02135-2065
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Country | US
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Telephone | 617-491-6766
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Fax | 617-491-2552
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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 | 2086S0105X
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Taxonomy Name | Surgery of the Hand (Surgery) Physician
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License Number | 236836
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License Number State | MA
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