Green, Debra J.

Green, Debra J. is an individual health care provider with primary practice located at 30 Bergen St Admc 12 1205, Newark NJ 07107-3000. She recently has only one registered license in Allopathic & Osteopathic Physicians / Diagnostic Radiology, which is considered as her primary health care specialty. Green, Debra J. can be contacted via phone (973) 972-0037.

Contact Information

Primary practice address
30 Bergen St Admc 12 1205 Newark NJ 07107-3000
Phone: (973) 972-0037
Fax: (973) 972-9355
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X 25MA05276300 New Jersey

Profile Details

NPI number 1194836890
LBN Legal business name Green, Debra J.
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 31st, 2006
Last updated Jul 8th, 2007 - about 19 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1194836890 NPPES
New Jersey MEDICAID 5213703

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