Green, Roger D

Green, Roger D is an individual health care provider with primary practice located at 550 Route 299 Suite 200, Highland NY 12528-2875. He recently has 2 registered licenses in different health care specialties including Other Service Providers / Specialist, Allopathic & Osteopathic Physicians / Pediatrics. Allopathic & Osteopathic Physicians / Pediatrics is his primary health care specialty. Green, Roger D can be contacted via phone (845) 231-5600.

Contact Information

Primary practice address
550 Route 299 Suite 200 Highland NY 12528-2875
Phone: (845) 231-5600
Fax: (845) 883-4406
Website:
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Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X 179477 New York
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 179477 New York

Profile Details

NPI number 1376591321
LBN Legal business name Green, Roger D
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 4th, 2006
Last updated Nov 17th, 2016 - about 10 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 1376591321 NPPES
New York MEDICAID 01258988

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