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NPI Code Detail

MEDICARE: DR. THOMAS ARLIS GREEN M.D.

MEDICARE:  DR. THOMAS ARLIS GREEN  M.D.
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
1207Q00000XFamily Medicine Physician157915NY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1538130075
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. THOMAS ARLIS GREEN M.D.
Provider Business Mailing Address
First Line : 1860 US ROUTE 20
Second Line :
City : CAZENOVIA
State : NY
Zip : 13035-9647
Country : US
Telephone Number : 315-655-3655
Fax Number :
Provider Business Practice Location Address
First Line : 1860 US ROUTE 20
Second Line :
City : CAZENOVIA
State : NY
Zip : 13035-9647
Country : US
Telephone Number : 315-655-3655
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/01/2006
Last Update Date : 01/18/2015

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