Provider Demographics
NPI:1851260822
Name:GREEN CARE CENTER LLC
Entity type:Organization
Organization Name:GREEN CARE CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:NAWSHIN
Authorized Official - Middle Name:
Authorized Official - Last Name:JAMIL
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:718-873-6893
Mailing Address - Street 1:4112 77TH ST
Mailing Address - Street 2:
Mailing Address - City:ELMHURST
Mailing Address - State:NY
Mailing Address - Zip Code:11373-1996
Mailing Address - Country:US
Mailing Address - Phone:718-873-6893
Mailing Address - Fax:
Practice Address - Street 1:4112 77TH ST
Practice Address - Street 2:
Practice Address - City:ELMHURST
Practice Address - State:NY
Practice Address - Zip Code:11373-1996
Practice Address - Country:US
Practice Address - Phone:718-873-6893
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-10-30
Last Update Date:2025-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain MedicineGroup - Multi-Specialty