Provider Demographics
NPI:1760005854
Name:COOTE-GREEN, PAULETTE ELAINE
Entity Type:Individual
Prefix:MS
First Name:PAULETTE
Middle Name:ELAINE
Last Name:COOTE-GREEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4223 HILL AVE FL 2
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10466-2107
Mailing Address - Country:US
Mailing Address - Phone:914-563-6017
Mailing Address - Fax:
Practice Address - Street 1:4223 HILL AVE # 2F
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10466-2107
Practice Address - Country:US
Practice Address - Phone:914-563-6017
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-22
Last Update Date:2020-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY778133-01163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163W00000XNursing Service ProvidersRegistered NurseGroup - Single Specialty