Wanda Green, RN

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

626905 Issued in NY

Practice address

475 New Hwy
Copiague, NY 11726-1027

Phone

(631) 245-1590

NPI assigned

Apr 19, 2010

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1271635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1271635200000",
    "number": "1790001576",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "475 NEW HWY",
            "city": "COPIAGUE",
            "state": "NY",
            "postal_code": "117261027",
            "telephone_number": "631-245-1590"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "475 NEW HWY",
            "city": "COPIAGUE",
            "state": "NY",
            "postal_code": "117261027",
            "telephone_number": "631-245-1590"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREEN",
        "first_name": "WANDA",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-04-19",
        "last_updated": "2010-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "626905",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nicole Giannini
• Gino Louis Giorgini Jr., MD
• Jenny Gomez
• Laura L Gorman
• Diana Elicia Grant, LMHC
• David Grossman, RN
• Fanchette Grunblatt, LMSW
• Krishna R S Gujavarty, MD
• Joshua Lee Gutierrez, L.A.C.
• Minako Hara, MA CCC SLP

• Registered Nurse in Copiague, NY
• Providers in Copiague, NY by specialty
• Registered Nurse in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2010; 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.