Green, Jonathan Martin

Green, Jonathan Martin is an individual health care provider with primary practice located at 1 Guthrie Sq , Sayre PA 18840-1625. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as his primary health care specialty. Green, Jonathan Martin can be contacted via phone (570) 888-5858.

Contact Information

Primary practice address
1 Guthrie Sq Sayre PA 18840-1625
Phone: (570) 888-5858
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X MA003263-L Pennsylvania
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 007516-1 New York

Profile Details

NPI number 1447210117
LBN Legal business name Green, Jonathan Martin
Credentials PAC
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 25th, 2006
Last updated Jul 29th, 2011 - about 14 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 1447210117 NPPES
New York MEDICAID 02104052
New York Other C8362
New York Other CC9269
New York Other GU039978
New York Other P00331479
New York Other 970015812

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