National Provider Identifier

Jonelle Olivia Green, OD

Jonelle Olivia Green, OD is listed in the NPPES registry with a primary specialty of Optometrist in Fredonia, NY and a listed phone number of (716) 679-3180.

NPI 1467960732Fredonia, NYOptometrist

Profile Overview

NPI
1467960732
Provider Type
Individual
Primary Specialty
Optometrist
Enumeration Date
January 19, 2018
Last Updated
January 19, 2018

Practice Location

  • 10401 Bennett RD
  • Fredonia, NY 14063-1402

Phone: (716) 679-3180

Mailing Address

  • 1816 W 24Th St
  • Erie, PA 16502-2022

Specialties

  • Optometrist (152W00000X)
Full Record
NPI
1467960732
Entity Type
Individual
Last Name
Green
First Name
Jonelle
Middle Name
Olivia
Credential
OD
Mailing Street Address
1816 W 24Th St
Mailing City
Erie
Mailing State
PA
Mailing ZIP Code
16502-2022
Mailing Country
US
Mailing Phone
(954) 559-1957
Practice Street Address
10401 Bennett RD
Practice City
Fredonia
Practice State
NY
Practice ZIP Code
14063-1402
Practice Country
US
Practice Phone
(716) 679-3180
Enumeration Date
January 19, 2018
Last Updated
January 19, 2018
Sex
Female
Sole Proprietor
Yes
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Optometrist (152W00000X)