# GLENDALE FAMILY MEDICINE,PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1346444734
- **Authorized official:** WAYNE SEBASTIANO MD (OWNER)
- **Authorized official phone:** (718) 386-8300

## Contact information

- **Practice address:** 7801 MYRTLE AVE, GLENDALE, NY 11385-7439
- **Practice address phone:** (718) 386-8300
- **Practice address fax:** (718) 386-0437
- **Mailing address:** 7801 MYRTLE AVE, GLENDALE, NY 11385-7439
- **Mailing address phone:** (718) 386-8300
- **Mailing address fax:** (718) 386-0437

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 168147 | NY | Yes |

## Other

- **Enumeration date:** 06/12/2007
- **Last updated:** 11/25/2015