Basic Information
| Provider Information | |||||||||
| NPI: | 1629169156 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | DR ANDREW GREEN DR RITA SLOAN AND DR ROLAND HONEINE LLP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3615 SENECA ST | ||||||||
| Address2: | |||||||||
| City: | WEST SENECA | ||||||||
| State: | NY | ||||||||
| PostalCode: | 142243444 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7166752660 | ||||||||
| FaxNumber: | 7166752663 | ||||||||
| Practice Location | |||||||||
| Address1: | 3615 SENECA ST | ||||||||
| Address2: | |||||||||
| City: | WEST SENECA | ||||||||
| State: | NY | ||||||||
| PostalCode: | 142243444 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7166752660 | ||||||||
| FaxNumber: | 7166752663 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/28/2006 | ||||||||
| LastUpdateDate: | 12/14/2021 | ||||||||
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| AuthorizedOfficialLastName: | GREEN | ||||||||
| AuthorizedOfficialFirstName: | ANDREW | ||||||||
| AuthorizedOfficialMiddleName: | W | ||||||||
| AuthorizedOfficialTitleorPosition: | PARTNER | ||||||||
| AuthorizedOfficialTelephone: | 7166752660 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
| NPICertificationDate: | 12/14/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207KA0200X | 124074 | NY | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Allergy & Immunology | Allergy |
No ID Information.