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Individual

DEBBIE GLASS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
97 AMITY ST FL 1, BROOKLYN, NY 11201
(929) 455-2500
Mailing address
97 AMITY ST FL 1, BROOKLYN, NY 11201-6004
(929) 455-2500

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
201869
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
113655027
PHCS PROVIDER ID #
01
180061302
UNITED HEALTHCARE PROV ID
01
4301733005
CIGNA HEALTHCARE PROV ID
01
P726043
OXFORD FREEDOM PROVIDER #
Enumeration date
12/15/2006
Last updated
04/01/2021
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