person
Mr. Kenneth R. Green, MD
Nephrology Physician in Syracuse, New York
NPI 1114909512

Kenneth R. Green is a Nephrology Physician based in Syracuse, NY and is specialized in Nephrology. Kenneth R. Green practices in Syracuse, NY and has the professional credentials of MD. The NPI Number for Kenneth R. Green is 1114909512 and holds a License No. 130245 (New York).

The current practice location address for Kenneth R. Green is 1304 Buckley Rd, Syracuse, NY and can be reached out via phone at 315-478-3311 and via fax at 315-426-0796.

Location: 1304 Buckley Rd, Syracuse, NY, 13212
person
Provider Profile Details
NPI Number
1114909512
Provider Name
Kenneth R. Green
Credential
MD
Provider Entity Type
Individual
Gender
Male
Address
1304 Buckley Rd, Syracuse, NY, 13212
Phone Number
315-478-3311
Fax Number
315-426-0796
Provider Enumeration Date
11/19/2005
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
10119425 01 NY CDPHP
000914917001 01 NY HEALTHNOW
3300208 01 NY GHI
00914917001 01 NY HEALTHNOW
100029112801 01 NY UNITED HEALTHCARE
719956 01 NY MVP
00581475 05 NY
03260 01 NY EXCELLUS
00040696502 01 NY UNIVERA SENIOR CHOICE
4535679 01 NY AETNA
institution
Provider Business Practice Location Address Details
Address
1304 Buckley Rd
City
State
Zip
13212-4302
Phone Number
315-478-3311
Fax Number
315-426-0796
person
Provider Business Mailing Address Details
Address
1304 Buckley Rd
City
State
Zip
13212-4302
Phone Number
315-478-3311
Fax Number
315-426-0796
person
Provider's Taxonomy Details 1
Type
Allopathic & Osteopathic Physicians
Classification
Internal Medicine
Speciality
Nephrology
Taxonomy
License No.
130245 (New York)
Definition
An internist who treats disorders of the kidney, high blood pressure, fluid and mineral balance and dialysis of body wastes when the kidneys do not function. This specialist consults with surgeons about kidney transplantation.
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