JACK GLADSTEIN (NPI# 1508870551) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1508870551 |
| Entity Type | Individual |
| Full Name | JACK GLADSTEIN |
| Credential | MD |
| Practice Address |
22 S Greene St Baltimore MD 21201-1544 |
| Mailing Address |
Po Box 62063 Baltimore MD 21264-2063 |
| Practice Telephone | 4103286749 |
| Practice Fax Number | 4103286136 |
| Mailing Telephone | 4107065181 |
| Mailing Fax Number | 4107065103 |
| Enumeration Date | 2006-07-27 |
| Last Update Date | 2017-03-02 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 208000000X | Pediatrics | D34944 | MD | Allopathic & Osteopathic Physicians |
| N | 2080A0000X |
Pediatrics Specialization: Adolescent Medicine |
D34944 | MD | Allopathic & Osteopathic Physicians |
| Y | 2084N0402X |
Psychiatry & Neurology Specialization: Neurology with Special Qualifications in Child Neurology |
D34944 | MD | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MD | 479431100 | 05 |
| Street Address |
22 S GREENE ST |
| City | BALTIMORE |
| State | MD |
| Zip Code | 21201-1544 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750383063 | Malinda Daniel Duke | Nurse Practitioner | 22 S Greene St, Rm N6w84, Baltimore, MD 21201-1544 | 2005-06-01 |
| 1891396784 | Tamara Wiseman | Nurse Practitioner | 22 S Greene St, Baltimore, MD 21201-1544 | 2020-11-05 |
| 1063012664 | Shawna Marie Hutton | Registered Nurse | 22 S Greene St, Baltimore, MD 21201-1590 | 2020-11-01 |
| 1124625413 | Kerry Ann Lambert | Pharmacist | 22 S Greene St, Baltimore, MD 21201-1590 | 2020-10-08 |
| 1730786104 | Joseph William Russo | Pediatrics | 22 S Greene St, Baltimore, MD 21201-1590 | 2020-10-07 |
| 1295342327 | Leah Marie Dubose | Nurse Practitioner | 22 S Greene St, Baltimore, MD 21201-1544 | 2020-09-23 |
| 1275147167 | Rosalynn Joy Allen | Registered Nurse | 22 S Greene St, Baltimore, MD 21201-1590 | 2020-09-08 |
| 1174137269 | Keiara Williams | Nurse Practitioner | 22 S Greene St, Baltimore, MD 21201-1544 | 2020-09-04 |
| 1699389858 | Caitlin Lauren Thomas | Nurse Practitioner | 22 S Greene St, Baltimore, MD 21201-1544 | 2020-09-04 |
| 1639782568 | Anna Pfouts | Nurse Practitioner | 22 S Greene St, Baltimore, MD 21201-1544 | 2020-08-29 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518585470 | Meshref Ayed Alshehri | Student in an Organized Health Care Education/Training Program | 22 S. Greene Street, Room N3e09, Baltimore, MD 21201 | 2020-07-08 |
| 1306462411 | Michael Julian Wong | Student in an Organized Health Care Education/Training Program | University of Maryland, Department of Anesthesiology, 22 S Green St, S11b, Baltimore, MD 21201 | 2020-06-24 |
| 1740817733 | Martha Kaitlyn Coghlan | Student in an Organized Health Care Education/Training Program | Ummc Ob/gyn, 22 S. Greene St., Baltimore, MD 21201 | 2020-03-27 |
| 1629606637 | Taylor Renee Kai | Student in an Organized Health Care Education/Training Program | University of Maryland, 22 S. Greene Street, Room N3e09, Baltimore, MD 21201 | 2020-03-27 |
| 1295362697 | Brittany A Oster | Student in an Organized Health Care Education/Training Program | 110 S. Paca Street 6th Floor, Suite 300, Baltimore, MD 21201 | 2020-03-25 |
| 1346877735 | Kayvon Michael Mobarakeh | Student in an Organized Health Care Education/Training Program | University of Maryland Department of Anesthesiology, 22 S Greene St, S11c, Baltimore, MD 21201 | 2020-03-25 |
| 1598392284 | Zachary Allan Hagen | Student in an Organized Health Care Education/Training Program | 110 S. Paca Street, 6th Flr., Suite 200, Baltimore, MD 21201 | 2020-03-24 |
| 1700430055 | Jaime Semchuk | Student in an Organized Health Care Education/Training Program | 737 West Lombard, Baltimore, MD 21201 | 2019-07-25 |
| 1952861619 | Zachary Daniel Sanford | Student in an Organized Health Care Education/Training Program | 22 S Greene Street S8b12, Baltimore, MD 21201 | 2019-03-20 |
| 1114487840 | Spencer Sykes Lovegrove | Student in an Organized Health Care Education/Training Program | 110 S. Paca Street, Sixth Floor, Suite 200, Baltimore, Sixth Floor, Suite 200, Baltimore, MD 21201 | 2019-03-20 |
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| Taxonomy Code | 2084N0402X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Neurology with Special Qualifications in Child Neurology |
| A Child Neurologist specializes in neurology with special skills in diagnosis and treatment of neurologic disorders of the neonatal period, infancy, early childhood, and adolescence. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063559268 | Kristin Whitford Baranano | Psychiatry & Neurology | 9910 Franklin Square Dr. Suite 2060, Johns Hopkins University- Clinical Practice Association, Baltimore, MD 21236-4902 | 2007-01-30 |
| 1528068939 | Joseph Scheller | Psychiatry & Neurology | 2501 Willow Glen Dr, Baltimore, MD 21209-3106 | 2005-07-28 |
| 1578957130 | Laura Malone | Psychiatry & Neurology | 1800 Orleans St Rm 8446, Baltimore, MD 21287-0010 | 2015-03-22 |
| 1457798290 | Juan Alfredo Caceres Noguera | Psychiatry & Neurology | 2401 W Belvedere Ave, Baltimore, MD 21215-5216 | 2013-06-03 |
| 1508108879 | Sinai Hospital of Baltimore, Inc | Psychiatry & Neurology | 2435 W Belvedere Ave, Suite 32, Baltimore, MD 21215-5224 | 2013-03-25 |
| 1467746156 | Samata Singhi | Psychiatry & Neurology | 600 N Wolfe Street, Meyer 2-147, Baltimore, MD 21287-0005 | 2011-05-31 |
| 1689972523 | Verena Staedtke | Psychiatry & Neurology | Johns Hopkins Hospital Department Of, 200 N Wolfe Street, Suite 2158, Baltimore, MD 21287-0001 | 2011-03-01 |
| 1083939326 | Jacqueline Harris | Psychiatry & Neurology | 707 N Broadway, Baltimore, MD 21205-1888 | 2010-03-30 |
| 1972833994 | Lisa Renee Sun | Psychiatry & Neurology | 1800 Orleans St, Room 8444, Baltimore, MD 21287-0010 | 2010-01-14 |
| 1487851721 | Ryan Felling | Psychiatry & Neurology | 200 N Wolfe St, Harriet Lane, Suite 2158, Baltimore, MD 21287-0011 | 2007-06-29 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.