Provider Demographics
NPI:1568448827
Name:GREEN, ALANA (CRNA)
Entity Type:Individual
Prefix:
First Name:ALANA
Middle Name:
Last Name:GREEN
Suffix:
Gender:F
Credentials:CRNA
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Mailing Address - Street 1:99 EAST RIVER DR 5TH FLOOR
Mailing Address - Street 2:MEDICAL ANESTHESIOLOGY ASSOCIATES PC
Mailing Address - City:EAST HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06108-7301
Mailing Address - Country:US
Mailing Address - Phone:860-282-4133
Mailing Address - Fax:860-289-0746
Practice Address - Street 1:2 TRAP FALLS RD
Practice Address - Street 2:SUITE 414
Practice Address - City:SHELTON
Practice Address - State:CT
Practice Address - Zip Code:06484-7623
Practice Address - Country:US
Practice Address - Phone:203-929-7353
Practice Address - Fax:203-929-0756
Is Sole Proprietor?:No
Enumeration Date:2005-12-19
Last Update Date:2014-09-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CT000377367H00000X
CT377367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No367H00000XPhysician Assistants & Advanced Practice Nursing ProvidersAnesthesiologist Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT004081725Medicaid
CT430000096Medicare PIN