John N Green, M.D.,PA

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

License

MA40057 Issued in NJ

Legal business name

JOHN N GREEN, M.D.,PA

Practice address

61 Main St
Suite B
West Orange, NJ 07052-5311

Phone

(973) 669-1111

Fax

(973) 669-3535

NPI assigned

Apr 4, 2007

Organization subpart

Yes

Parent organization

JOHN N GREEN, M.D.,PAAs reported in NPPES

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

Authorized official

Name

Dr. John Nezzel Green, M.D.

Title

President

Phone

(973) 669-1111

Specialties & licenses 1

Addresses

Part of

John N Green Mdpa

Locations

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

{
    "created_epoch": "1175644800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1342137600000",
    "number": "1417079062",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "61 MAIN ST",
            "address_2": "SUITE B",
            "city": "WEST ORANGE",
            "state": "NJ",
            "postal_code": "070525311",
            "telephone_number": "973-669-1111",
            "fax_number": "973-669-3535"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "61 MAIN ST",
            "address_2": "SUITE B",
            "city": "WEST ORANGE",
            "state": "NJ",
            "postal_code": "070525311",
            "telephone_number": "973-669-1111",
            "fax_number": "973-669-3535"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOHN N GREEN, M.D.,PA",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "JOHN N GREEN, M.D.,PA",
        "enumeration_date": "2007-04-04",
        "last_updated": "2012-07-13",
        "status": "A",
        "authorized_official_last_name": "GREEN",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "NEZZEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "973-669-1111",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "NJ",
            "license": "MA40057",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Gastroenterology Physician in West Orange, NJ
• Providers in West Orange, NJ by specialty
• Gastroenterology Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2012; 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.