Most Relevant Information
Provider Data
| NPI Number: | 1003345505 |
| Provider Name: | SIERRA GREEN |
| Entity Type: | Individual |
| Taxonomy Code: | 174H00000X |
| Specialty: | Health Educator |
| License Number: | 100476 |
Most Important Dates
| Enumeration Date: | 06/08/2017 |
| Last Updated: | 07/21/2022 |
Provider Practice Location
4 FERN PLACE
PLAINVIEW
NY
11803
Practice Location Phone/Fax
| Phone: | 5169334700 |
| Fax: | 5166530110 |
Provider Mailing Location
4 FERN PL
PLAINVIEW
NY
118034725
Provider Mailing Phone/Fax
| Phone: | 5169334700 |
| Fax: | 5166530110 |