MEDICARE: DR. LYNN DANIELLE 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
1	2084P0804X	Child & Adolescent Psychiatry Physician	211522-1	NY

General Provider Information

NPI Number	:	1932438660
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LYNN DANIELLE GREEN MD

Provider Business Mailing Address
First Line	:	14 MAGNOLIA DR
Second Line	:
City	:	PURCHASE
State	:	NY
Zip	:	10577-1134
Country	:	US
Telephone Number	:	914-325-9472
Fax Number	:	914-421-0537

Provider Business Practice Location Address
First Line	:	34 S BROADWAY
Second Line	:
City	:	WHITE PLAINS
State	:	NY
Zip	:	10601-4400
Country	:	US
Telephone Number	:	914-325-9472
Fax Number	:	914-421-0537

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

Provider Enumeration Date	:	12/08/2009
Last Update Date	:	06/22/2026

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