Provider Demographics
NPI:1528339546
Name:GREEN, WILLIAM HENRY
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:HENRY
Last Name:GREEN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 JOHNSON AVE
Mailing Address - Street 2:
Mailing Address - City:CRANFORD
Mailing Address - State:NJ
Mailing Address - Zip Code:07016-2639
Mailing Address - Country:US
Mailing Address - Phone:908-709-1010
Mailing Address - Fax:
Practice Address - Street 1:30 JOHNSON AVE
Practice Address - Street 2:
Practice Address - City:CRANFORD
Practice Address - State:NJ
Practice Address - Zip Code:07016-2639
Practice Address - Country:US
Practice Address - Phone:908-709-1010
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-23
Last Update Date:2022-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker