Provider Demographics
NPI:1174578470
Name:LASALLE-GREEN, NOREEN M (MD)
Entity type:Individual
Prefix:
First Name:NOREEN
Middle Name:M
Last Name:LASALLE-GREEN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:14 RICE RD
Mailing Address - Street 2:
Mailing Address - City:TEMPLETON
Mailing Address - State:MA
Mailing Address - Zip Code:01468-1332
Mailing Address - Country:US
Mailing Address - Phone:978-939-2035
Mailing Address - Fax:978-939-2039
Practice Address - Street 1:14 RICE RD
Practice Address - Street 2:
Practice Address - City:TEMPLETON
Practice Address - State:MA
Practice Address - Zip Code:01468-1332
Practice Address - Country:US
Practice Address - Phone:978-939-2035
Practice Address - Fax:978-939-2039
Is Sole Proprietor?:No
Enumeration Date:2006-05-24
Last Update Date:2016-08-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA400412085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA042477296OtherPRIVATE HEALTH CARE SYSTE
MA040041OtherTUFTS HEALTH PLAN
MA2065061OtherHEALTHY START
MA72312OtherCIGNA
MAN01776OtherBLUE CROSS BLUE SHIELD
MA042477296OtherHEALTH CARE VALUE MANAGEM
MA300041885OtherRAILROAD MEDICARE
MA40012OtherHEALTH NEW ENGLAND
MA0007041OtherNEIGHBORHOOD HEALTH PLAN
MA2065061Medicaid
MA042477296OtherUNITED HEALTH CARE
MA24944OtherHARVARD PILGRIM HEALTH CA
MA38747OtherFALLON COMMUNITY HEALTH P
MA24944OtherHARVARD PILGRIM HEALTH CA
MAN01776Medicare ID - Type Unspecified