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Yaakov Samuel Green

Student in an Organized Health Care Education/Training Program

Student, Health Care

1051 Riverside Dr # 103, New York, NY 10032-1007

PECOS Enrollment

This provider is enrolled in PECOS as YAAKOV GREEN.

Based on the most recent information from CMS, provider Yaakov Samuel Green is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records yesterday at 10:51 AM.

Profile Details

Provider ID
1124761770
Provider Type
Individual
Full Name
Green, Yaakov Samuel
Credential
MD

Gender
Male
Sole Proprietor
No
Enumeration Date
4/20/2022
Last Updated
8/21/2024

Contact Information

Practice Location

1051 Riverside Dr # 103, New York, NY 10032-1007

(646) 774-6302

(256) 662-6919

Mailing Location

1051 Riverside Dr # 103, New York, NY 10032-1007

Unlisted Phone

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 390200000X Primary	Description Student in an Organized Health Care Education/Training Program Student, Health Care	License Unlisted Issuer

Yaakov Samuel Green

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Ramsey, Natalie

Wang, Crystal C

Samuel, Nina

Frankel, Joseph

Stern Shavit, Sagit

Thompson, Adrian

Curbelo Pena, Yuhamy Mitsahid

Liu, Melissa Fung Wah

Ehrlich, Matthew

Berhe, Simon