Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Deandra Green

Individual provider Family Nurse Practitioner · NPI 1356233597

Deandra Green is a Nurse Practitioner in Glen Oaks, New York. Qualified in 2025, 1 year ago. Practices as a sole proprietor. Licensed in New York.

Years since qualifying
1
Licensed in
NY
In the registry since
2025

Practice location Address checks out

75-59 263rd St
Glen Oaks, NY 11004
Phone: (718) 470-8100
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence F357105-01 (NY)

Record details

NPI number1356233597
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedJuly 21, 2025
Last updated in NPPESJuly 21, 2025
Certification dateJuly 20, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2025 (1 years in practice)
Accepts Medicare assignment Not indicated
Practice locations2 on file with Medicare

Other providers in Glen Oaks