MR. SHAY F GREEN (NPI# 1255520060) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1255520060 |
| Entity Type | Individual |
| Full Name | MR. SHAY F GREEN |
| Credential | APRN |
| Practice Address |
28 Crescent St Middletown CT 06457-3654 |
| Practice Telephone | 8603585322 |
| Practice Fax Number | 8603586298 |
| Mailing Telephone | 8603585322 |
| Mailing Fax Number | 8603586298 |
| Enumeration Date | 2007-10-17 |
| Last Update Date | 2014-03-11 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363L00000X | Nurse Practitioner | 003655 | CT | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 363LA2100X |
Nurse Practitioner Specialization: Acute Care |
003655 | CT | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CT | HEALTHNET | 3V0093 | 01 |
| CT | ANTHEM | 400003655CT | 01 |
| Street Address |
28 CRESCENT ST |
| City | MIDDLETOWN |
| State | CT |
| Zip Code | 06457-3654 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790788859 | Eric B Neadel | Physician Assistant | 28 Crescent St, Middletown, CT 06457-3654 | 2005-05-23 |
| 1861001729 | Adrianne Lynn Wyckoff | Registered Nurse | 28 Crescent St, Middletown, CT 06457-3650 | 2020-07-27 |
| 1639791577 | Peder Johnsen | Nurse Practitioner | 28 Crescent St, Middletown, CT 06457-3654 | 2020-05-14 |
| 1275171530 | Lisa Ann Tringali | Recreation Therapist | 28 Crescent St, Middletown, CT 06457-3654 | 2019-12-18 |
| 1528600160 | Antonella Rosa Sferrazza | Counselor | 28 Crescent St, Middletown, CT 06457-3654 | 2019-10-15 |
| 1548801830 | Michael Tammaro | Physician Assistant | 28 Crescent St, Middletown, CT 06457-3654 | 2019-10-08 |
| 1699240705 | Mary Theresa Doyle | Social Worker | 28 Crescent St, Middletown, CT 06457-3650 | 2018-10-05 |
| 1649761040 | Emily Eklof | Nurse Practitioner | 28 Crescent St, Middletown, CT 06457 | 2018-05-22 |
| 1285141077 | Christine O'grady | Social Worker | 28 Crescent St, Middletown, CT 06457-3654 | 2018-01-03 |
| 1871022293 | Jacqueline Mary Atkinson | Physician Assistant | 28 Crescent St, Middletown, CT 06457-3654 | 2017-06-08 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699391961 | Meghan Harrington | Behavior Technician | 101 Centerpoint Drive #243, Middletown, CT 06457 | 2020-06-22 |
| 1427619626 | Collaborative Aba Services, LLC | Behavioral Analyst | 515 Centerpoint Drive, Suite 205, Middletown, CT 06457 | 2019-06-27 |
| 1376100339 | Kimberly Tynik | Pharmacist | 451 Fowler Ave, Middletown, CT 06457 | 2019-05-24 |
| 1184101263 | Tabrez Adil | Dentist | 675 Main St., Middletown, CT 06457 | 2018-07-23 |
| 1326535337 | Rehan Khan | Non-emergency Medical Transport (VAN) | 765 Country Club Rd, Middletown, CT 06457 | 2018-04-16 |
| 1366950206 | State of Connecticut | Psychiatric Hospital | 70 O'brien Drive, Middletown, CT 06457 | 2018-01-12 |
| 1902324536 | Cynthia Tine | Physical Therapy Assistant | 628 Congdon Street, Middletown, CT 06457 | 2017-09-04 |
| 1619494390 | Nathan Douglas Roy | Specialist/Technologist | 431 Briarwood Lane, Middletown, CT 06457 | 2017-08-24 |
| 1598286502 | Rachel Hoffman Whelen | Registered Nurse | 420 Saybrook Road, Suite A, Middletown, CT 06457 | 2017-06-29 |
| 1003358326 | Rebecca Rotondo | Social Worker | 230 Main Street Extension, Act Team, Gilead Community Services, Middletown, CT 06457 | 2016-11-17 |
| Find all providers in zip 06457 | ||||
| Taxonomy Code | 363LA2100X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Acute Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801375605 | Cecelia Glynn Echevarria | Nurse Practitioner | 25 John Kesson Ln, Middletown, RI 02842-4654 | 2018-08-13 |
| 1881998060 | Debra Lynn Mcgrath | Nurse Practitioner | 6 Brookline Ct, Middletown, NJ 07748-3302 | 2011-01-03 |
| 1164405619 | Rebecca Lynn Edwards | Nurse Practitioner | 28 Crescent Street, Middlesex Hospital Hospice and Palliative Care, Middletown, CT 06457 | 2005-11-29 |
| 1396358552 | Rachel Chassen | Nurse Practitioner | 707 E Main St, Middletown, NY 10940-2650 | 2020-08-27 |
| 1902380363 | Bryan David Godduhn | Nurse Practitioner | 536 Saybrook Rd, Middletown, CT 06457-4783 | 2018-09-21 |
| 1912492075 | Paul Gyorgyfi | Nurse Practitioner | 1 Medical Center Dr, Middletown, OH 45005 | 2018-06-29 |
| 1760905756 | Jennifer Nicole Selby | Nurse Practitioner | 707 E Main St, Middletown, NY 10940-2650 | 2017-07-20 |
| 1679093801 | Anthony Rella | Nurse Practitioner | 707 E Main St, Middletown, NY 10940-2650 | 2017-06-20 |
| 1972033058 | Callie Marie Schlosser | Nurse Practitioner | 707 E Main St, Middletown, NY 10940-2650 | 2017-06-12 |
| 1669821716 | Kelsey Kies | Nurse Practitioner | 1 Medical Center Dr Fl 3, Middletown, OH 45005 | 2016-06-09 |
| Find all providers in MIDDLETOWN | ||||
| City | MIDDLETOWN |
| Zip Code | 06457 |
Please comment or provide details below to improve the information on MR. SHAY F GREEN.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.