EDWARD H GLENN (NPI# 1922010776) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1922010776 |
Entity Type | Individual |
Full Name | EDWARD H GLENN |
Credential | MD |
Practice Address |
80 Maple Avenue Smithtown NY 11787 |
Practice Telephone | 6312655777 |
Practice Fax Number | 6312655797 |
Mailing Telephone | 6312655777 |
Mailing Fax Number | 6312655797 |
Enumeration Date | 2006-08-12 |
Last Update Date | 2009-08-24 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
094600 | NY | Allopathic & Osteopathic Physicians |
State | Issuer | Identifier | Type Code |
---|---|---|---|
NY | 00657167 | 05 |
Street Address |
80 MAPLE AVENUE |
City | SMITHTOWN |
State | NY |
Zip Code | 11787 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1710140116 | John H Lee Dmd PC | Dentist | 80 Maple Avenue, Suite 208, Smithtown, NY 11787 | 2008-07-07 |
1558373308 | Charles T Sitrin | Radiology | 80 Maple Avenue, Smithtown, NY 11787 | 2006-08-12 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1558962779 | Gwendolyn Burris | Counselor | 20 Gilbert Avenue, Suite 107-a, Smithtown, NY 11787 | 2020-11-04 |
1467051193 | Karin M Caro | Adult Companion | 9 Three Pond Road, Smithtown, NY 11787 | 2020-10-23 |
1639706641 | Nimit Khara | Student in an Organized Health Care Education/Training Program | 240 Middle Country Rd A, Smithtown, NY 11787 | 2020-03-27 |
1003469032 | Maria Teresa Gardella | Nurse Practitioner | St. Catherine of Siena Medical Center, 50 Ny-25a, Smithtown, NY 11787 | 2019-07-18 |
1558922070 | Pamella Ann Grillo | Physician Assistant | 373 Ny-111 #5, Smithtown, NY 11787 | 2019-06-25 |
1306308127 | Sherry Hansen | Social Worker | 285 Middle Country Rd, Suite Ll5, Smithtown, NY 11787 | 2019-04-01 |
1932663747 | Kayla Roundsman | Counselor | 11 Route 11, Smithtown, NY 11787 | 2019-01-25 |
1568959856 | Moreen Johnson | Registered Nurse | Christian Nursing Registry, 17 Bank Ave, Smith Town, NY 11787 | 2018-04-23 |
1992217871 | Erica Zeller Licensed Clinical Social Work Pllc | Social Worker | 15 Bellemeade Ave Ste 3, Smithtown, NY 11787 | 2017-10-31 |
1881117802 | Oisin Vincent Keenan | Case Manager/Care Coordinator | 11 Ny-111, Smithtown, NY 11787 | 2017-07-21 |
Find all providers in zip 11787 |
Taxonomy Code | 2085R0202X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Radiology |
Specialization | Diagnostic Radiology |
A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1942261128 | Suffolk Mri PC | Radiology | 987 W Jericho Tpke, Smithtown, NY 11787-3203 | 2006-03-29 |
1558373308 | Charles T Sitrin | Radiology | 80 Maple Avenue, Smithtown, NY 11787 | 2006-08-12 |
1558386219 | Radiology Health Services, PC | Radiology | 800 Maple Ave, Smithtown, NY 11787 | 2006-07-13 |
1619908100 | Radiologic Health Services Mri of Smithtown PC | Radiology | 80 Maple Ave, Smithtown, NY 11787 | 2006-07-05 |
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---|---|---|---|---|
1558960690 | New York Medical Diagnostic Imaging PC | Radiology | 13617 39th Ave Ste 1d, Flushing, NY 11354-5504 | 2020-10-20 |
1700490034 | Hudson Valley Radiologists, PC | Radiology | 33 Bridgewater Way, Poughkeepsie, NY 12601-5961 | 2020-09-03 |
1730702986 | Hudson Valley Radiologists, PC | Radiology | 17 Argent Dr, Poughkeepsie, NY 12603-6040 | 2020-05-22 |
1114540366 | Hudson Valley Radiologists, PC | Radiology | 12 Caliguiri Ct, Lagrangeville, NY 12540-4912 | 2020-05-22 |
1831712082 | Hudson Valley Radiologists, PC | Radiology | 23 Sommerset Rd, Poughkeepsie, NY 12603 | 2020-05-22 |
1124641378 | Hudson Valley Radiologists, PC | Radiology | 49 Evergreen Ave, Poughkeepsie, NY 12601-5206 | 2020-05-22 |
1023631272 | Hudson Valley Radiologists, PC | Radiology | 3 Riding Ridge Trl, Beacon, NY 12508-7023 | 2020-05-22 |
1740803998 | Hudson Valley Radiologists, PC | Radiology | 36 Pine St Apt 229, Poughkeepsie, NY 12601-3974 | 2020-05-22 |
1215550462 | Hudson Valley Radiologists, PC | Radiology | 50 Leonard St Unit 106, Beacon, NY 12508-3455 | 2020-05-22 |
1285257519 | Hudson Valley Radiologists, PC | Radiology | 14 Hilee Rd, Rhinebeck, NY 12572-2347 | 2020-05-21 |
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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.