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:
Health care specialties
| Specialty | Code | License # | 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 18 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 | 1194836890 | NPPES |
| New Jersey | MEDICAID | 5213703 |
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