Individual
MR. JERRY GLOSTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1795 LEXINGTON AVE, NEW YORK, NY 10029-2866
(212) 289-1788
(212) 289-2430
Mailing address
1795 LEXINGTON AVE, NEW YORK, NY 10029-2866
(212) 289-1788
(212) 289-2430
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
21708
NY
104100000X
Social Worker
—
NY
Other
Enumeration date
10/21/2015
Last updated
10/21/2015
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