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NPI Code Detail

MEDICARE: PATRICIA GREEN MD

MEDICARE:   PATRICIA  GREEN  MD
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
1208000000XPediatrics Physician25MA10341200NJ
2208000000XPediatrics PhysicianMD048038DC

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 : 1578950390
Entity Type Code : Individual
Provider Name (Legal Business Name) : PATRICIA GREEN MD
Provider Business Mailing Address
First Line : 4414 BENNING RD NE
Second Line :
City : WASHINGTON
State : DC
Zip : 20019-4555
Country : US
Telephone Number : 202-469-4699
Fax Number :
Provider Business Practice Location Address
First Line : 4414 BENNING RD NE
Second Line :
City : WASHINGTON
State : DC
Zip : 20019-4555
Country : US
Telephone Number : 202-388-7758
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/20/2015
Last Update Date : 06/23/2022

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Directions to “ PATRICIA GREEN MD” Practice Location

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