Provider Demographics
NPI:1427098839
Name:GREEN, ROBERT P (MD)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:P
Last Name:GREEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1060 PARK AVE APT 14G
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10128-1035
Mailing Address - Country:US
Mailing Address - Phone:914-329-3075
Mailing Address - Fax:
Practice Address - Street 1:150 E 58TH ST FL 34
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10155-3499
Practice Address - Country:US
Practice Address - Phone:212-722-5570
Practice Address - Fax:212-722-4573
Is Sole Proprietor?:No
Enumeration Date:2006-06-07
Last Update Date:2023-12-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY134895207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYW23611Medicare ID - Type Unspecified
NYC07211Medicare UPIN