GLENN GILBERG (NPI# 1770603755) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770603755 |
| Entity Type | Individual |
| Full Name | GLENN GILBERG |
| Credential | PA |
| Practice Address |
6870 E Genesee St Fayetteville NY 13066-1031 |
| Mailing Address |
259 1st St Mineola NY 11501-3957 |
| Practice Telephone | 3156794367 |
| Practice Fax Number | 3156794368 |
| Mailing Telephone | 5166630333 |
| Mailing Fax Number | 5166638549 |
| Enumeration Date | 2007-03-31 |
| Last Update Date | 2018-06-16 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363A00000X | Physician Assistant | Physician Assistants & Advanced Practice Nursing Providers | ||
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
006260 | NY | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 2549 Vestal Pkwy E Ste 3, Vestal, NY 138502084 | 6072250566 | 6072250557 |
| 3504 W Genesee St, Syracuse, NY 132192008 | 3154010754 | 3154010755 |
| 3648 Dewey Ave, Rochester, NY 146163026 | 5857363503 | 5855812961 |
| 5001 State Highway 23, Oneonta, NY 138204508 | 6073765346 | 6073765347 |
| 6227 Thompson Rd, Syracuse, NY 132061405 | 3159372007 | 3159372008 |
| 7375 Oswego Rd Ste 1, Liverpool, NY 130903717 | 3152910064 | 3152910065 |
| 8003 Brewerton Rd, Cicero, NY 130399528 | 3152884006 | 3152884760 |
| Street Address |
6870 E GENESEE ST |
| City | FAYETTEVILLE |
| State | NY |
| Zip Code | 13066-1031 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376169748 | Kaytlyn Flansburgh | Nurse Practitioner | 6870 E Genesee St, Fayetteville, NY 13066-1031 | 2020-06-22 |
| 1326609314 | Vanette Zalocha | Nurse Practitioner | 6870 E Genesee St, Fayetteville, NY 13066-1031 | 2019-06-21 |
| 1093120057 | Wellnow Urgent Care, PC | Family Medicine | 6870 E Genesee St, Fayetteville, NY 13066-1031 | 2014-06-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457819963 | Word Wellness Center, LLC | Psychologist | 6836 E Genesee Street, Suite A, Fayetteville, NY 13066 | 2019-03-05 |
| 1629529060 | Lorna Boyer Chase | Marriage & Family Therapist | 109 White Heron Circle, Fayetteville, NY 13066 | 2016-10-20 |
| 1699221432 | Roman Batyuk | Nurse Practitioner | 4100 Medical Center Drive, Fayetteville, NY 13066 | 2016-08-31 |
| 1427405133 | National Eye Care, Inc | Optometrist | 5160 Kinloch Circle, Fayetteville, NY 13066 | 2016-05-23 |
| 1013375328 | Kristin Kukenberger | Chiropractor | 7000 E Genesee St Bldg B, Fayetteville, NY 13066 | 2016-02-01 |
| 1124394671 | Susan Hartman Brenizer | Marriage & Family Therapist | 7000 E Genesee St Lyndon Office Park, Bldg. A, Second Floor (upper Level), Fayetteville, NY 13066 | 2012-03-29 |
| 1245541432 | Rene L Converse | Occupational Therapist | 7200 E. Genesee Street, Fayetteville, NY 13066 | 2010-06-23 |
| 1689815805 | Menorah Park Group Residents | Clinic/Center | 12 Jamar Drive, Dewitt, NY 13066 | 2009-03-18 |
| 1063677458 | John Marcena Glezen | Obstetrics & Gynecology | 1 The Gazebo, Fayetteville, NY 13066 | 2008-07-24 |
| 1629232418 | Tucker Martin Harris | Otolaryngology | 4000 Medical Center Dr # 117, Fayetteville, NY 13066 | 2008-07-11 |
| Find all providers in zip 13066 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245860618 | Robert Maughan | Physician Assistant | 129 Bryce Creek Ln, Fayetteville, NC 28303-4981 | 2020-01-24 |
| 1578050480 | Marlee Anne Fallon | Physician Assistant | 4402 Medical Center Dr Ste 402, Fayetteville, NY 13066-6626 | 2018-04-16 |
| 1285149781 | Rebecca Anderson | Physician Assistant | 413 Owen Dr Ste 201, Fayetteville, NC 28304-3490 | 2017-12-06 |
| 1750807186 | Julia Niemi | Physician Assistant | 2409 Murchison Rd # B, Fayetteville, NC 28301-3519 | 2017-08-17 |
| 1548709991 | Pallavi Annamaneni | Physician Assistant | 2149 Valleygate Dr Ste 102, Fayetteville, NC 28304-3666 | 2017-02-17 |
| 1124457650 | Amanda Warden | Physician Assistant | 89 Cowley Hollow Rd, Fayetteville, TN 37334-6947 | 2013-11-05 |
| 1639473739 | Andrea Bethauser | Physician Assistant | 918 Hope Mills Rd, Fayetteville, NC 28304-4243 | 2011-01-04 |
| 1891928941 | Gladys Maria Rivero | Physician Assistant | 3450 Sandystone Cir, Fayetteville, NC 28311-2503 | 2009-08-24 |
| 1366524092 | Lisa Aldrin Rojeski | Physician Assistant | 4038 N Remington Dr, Suite 4, Fayetteville, AR 72703-6345 | 2006-10-20 |
| 1902829039 | Michael John Winn | Physician Assistant | 5511 Raeford Road, Suite 150, Fayetteville, NC 28304-2058 | 2006-07-26 |
| Find all providers in FAYETTEVILLE | ||||
| City | FAYETTEVILLE |
| Zip Code | 13066 |
Please comment or provide details below to improve the information on GLENN GILBERG.
| 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.