Green, Mary Etosha

Green, Mary Etosha is an individual health care provider with primary practice located at 71 Haynes St , Manchester CT 06040-4131. She recently has 2 registered licenses in different health care specialties including Student, Health Care / Student in an Organized Health Care Education/Training Program, Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology. Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology is her primary health care specialty. Green, Mary Etosha can be contacted via phone (860) 646-1222.

Contact Information

Primary practice address
71 Haynes St Manchester CT 06040-4131
Phone: (860) 646-1222
Fax: (866) 623-8110
Website:
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Health care specialties

SpecialtyCodeLicense #State
Student, Health Care / Student in an Organized Health Care Education/Training Program 390200000X
Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology 207ZP0102X 74633 Connecticut

Profile Details

NPI number 1154827350
LBN Legal business name Green, Mary Etosha
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 5th, 2018
Last updated Aug 14th, 2023 - about 2 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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