Brandon Green

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

License

G73050966102892 Issued in NJ

Practice address

300 Huntingdon Dr
Williamstown, NJ 08094-8830

Phone

(619) 694-7780

NPI assigned

Aug 26, 2014

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1409011200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1409011200000",
    "number": "1003216177",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 HUNTINGDON DR",
            "city": "WILLIAMSTOWN",
            "state": "NJ",
            "postal_code": "080948830",
            "telephone_number": "619-694-7780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 HUNTINGDON DR",
            "city": "WILLIAMSTOWN",
            "state": "NJ",
            "postal_code": "080948830",
            "telephone_number": "619-694-7780"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREEN",
        "first_name": "BRANDON",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-08-26",
        "last_updated": "2014-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "NJ",
            "license": "G73050966102892",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NJ",
            "license": "G73050966102892",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Richard F Golden, DO
• Samir Goodman, NP
• Talia Gottlieb, DMD
• Kelly Jo Gramm, APN
• Shirley Ann Graves, CCC/SLP
• Noelle Marie Green, M. ED., BCABA
• Belle Greer
• Corey Lynn Grisi, MA CCC-SLP
• Joseph Patrick Haley, DPM
• Megan Eileen Hargrave, D.O.

• Student in an Organized Health Care Education/Training Program in Williamstown, NJ
• Providers in Williamstown, NJ by specialty
• Student in an Organized Health Care Education/Training Program in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.