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1316323090
IVAN GREENE
BRONX, NY
NPI
1316323090
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2015-08-05
Last Update Date
2015-08-05
Business Address
-- IVAN GREENE
1776 CLAY AVE
BRONX, NY 10457
Phone number: 718-960-7503
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Mailing Address
-- IVAN GREENE
1776 CLAY AVE
BRONX, NY 10457
Phone number: 718-960-7503
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