Most Relevant Information
Provider Data
| NPI Number: | 1003216177 |
| Provider Name: | BRANDON GREEN |
| Entity Type: | Individual |
| Taxonomy Code: | 2255A2300X |
| Specialty: | Specialist/Technologist |
| License Number: | G73050966102892 |
Most Important Dates
| Enumeration Date: | 08/26/2014 |
| Last Updated: | 08/26/2014 |
Provider Practice Location
300 HUNTINGDON DR
WILLIAMSTOWN
NJ
080948830
Practice Location Phone/Fax
| Phone: | 6196947780 |
| Fax: |
Provider Mailing Location
300 HUNTINGDON DR
WILLIAMSTOWN
NJ
080948830
Provider Mailing Phone/Fax
| Phone: | 6196947780 |
| Fax: |