Greene, Jerry
Greene, Jerry is an sole proprietor health care provider with primary practice located at 1400 Vfw Pkwy C/O Medical Service 111, West Roxbury MA 02132. He recently has only one registered license in Allopathic & Osteopathic Physicians / Rheumatology, which is considered as his primary health care specialty. Greene, Jerry can be contacted via phone (617) 323-7700.Contact Information
Primary practice address
1400 Vfw Pkwy C/O Medical Service 111
West Roxbury MA 02132
Phone: (617) 323-7700
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Rheumatology | 207RR0500X | 45681 | Massachusetts |
Profile Details
| NPI number | 1144318916 |
|---|---|
| LBN Legal business name | Greene, Jerry |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Oct 10th, 2006 |
| Last updated | Aug 31st, 2009 - about 17 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1144318916 | NPPES |
| Massachusetts | MEDICAID | 3060019 |
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