MEDICARE: MARIE GREEN RN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163W00000X	Registered Nurse	286583-1	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	286583-1	OTHER	NY	LICENSE

General Provider Information

NPI Number	:	1164601837
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARIE GREEN RN

Provider Business Mailing Address
First Line	:	45 GIRARD AVE
Second Line	:
City	:	BAY SHORE
State	:	NY
Zip	:	11706-8228
Country	:	US
Telephone Number	:	631-968-9102
Fax Number	:

Provider Business Practice Location Address
First Line	:	9 4TH AVE
Second Line	:
City	:	BAY SHORE
State	:	NY
Zip	:	11706-7908
Country	:	US
Telephone Number	:	631-968-9102
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/30/2007
Last Update Date	:	10/30/2007

Similar Medicare Providers

1124034558 — CATHOLIC CHARITIES OF THE DIOCESE OF ROCKVILLE CENTRE
Practice Location Address:

9 4TH AVE
BAY SHORE, NY
11706-7908

Practice Phone: 631-665-6707
Practice Fax:

1609930015 — MS. MARYELLEN BLANK NP
Practice Location Address:

21 4TH AVE
BAY SHORE, NY
11706-7908

Practice Phone: 631-665-6707
Practice Fax: 631-665-3564

1043362239 — SUSAN AIKEN NPP
Practice Location Address:

9 4TH AVE
BAY SHORE, NY
11706-7908

Practice Phone: 631-665-6707
Practice Fax:

1982756938 — JEAN M SCHULT LCSW
Practice Location Address:

21 4TH AVE
BAY SHORE, NY
11706-7908

Practice Phone: 631-665-6707
Practice Fax:

1790816510 — DR. MANJUMMELKUDIYIL P KURUVILLA MD
Practice Location Address:

9 4TH AVE
BAY SHORE, NY
11706-7908

Practice Phone: 631-968-9102
Practice Fax:

1871618223 — ADELAIDE CORVELLE
Practice Location Address:

9 4TH AVE
BAY SHORE, NY
11706-7908

Practice Phone: 631-665-6707
Practice Fax:

Directions to “ MARIE GREEN RN” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.