Individual ProviderShanae GreenRegistered NurseNursing Service ProvidersPractice Address35 Vincent Dr, Middletown, NY 10940-2932(845) 661-9917PECOS EnrollmentBased on the most recent information from CMS, provider Shanae Green does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1760834683Provider TypeIndividualFull NameGreen, ShanaeGenderFemaleSole ProprietorYesEnumeration Date7/2/2016Last Updated7/2/2016Contact InformationPractice LocationPractice Address35 Vincent Dr, Middletown, NY 10940-2932Phone(845) 661-9917FaxUnlisted FaxMailing LocationMailing Address35 Vincent Dr, Middletown, NY 10940-2932Phone(845) 661-9917FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode163W00000XPrimaryDescriptionRegistered NurseNursing Service ProvidersLicense688130New York