Green, Jerry A.

Green, Jerry A. is an sole proprietor health care provider with primary practice located at 67 Aunt Hack Rd , Danbury CT 06811-2720. He recently has only one registered license in Other Service Providers / Specialist, which is considered as his primary health care specialty. Green, Jerry A. can be contacted via phone (203) 798-6566.

Contact Information

Primary practice address
67 Aunt Hack Rd Danbury CT 06811-2720
Phone: (203) 798-6566
Fax: (203) 790-5883
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X 023599 Connecticut

Profile Details

NPI number 1497734347
LBN Legal business name Green, Jerry A.
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jan 10th, 2006
Last updated Apr 9th, 2020 - about 5 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 1497734347 NPPES
Connecticut MEDICAID 001235993

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