Individual
GLENNE GLASSBERG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RDN
Contact information
Practice address
1094 FULTON ST, WOODMERE, NY 11598
(570) 878-3642
Mailing address
960 W BROADWAY, WOODMERE, NY 11598-1647
(570) 878-3642
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
86066215
NY
133VN1004X
Pediatric Nutrition Registered Dietitian
86066215
NY
133VN1005X
Renal Nutrition Registered Dietitian
86066215
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
86066215
—
NY
Enumeration date
06/19/2018
Last updated
11/08/2019
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