NPIMap

Organization Active NPI

Glenn a Brottman MD PC

  • Psychiatry Physician
  • New York, NY
National Provider Identifier
1104076165
Registry record updated Mar 4, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
240287 Issued in NY
Legal business name
GLENN A BROTTMAN MD PC
Practice address
119 West 57TH Street
Suite 1101
New York, NY 10019
Phone
(212) 969-1899
Fax
(212) 969-1898
NPI assigned
Sep 26, 2008
Last updated
Mar 4, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2009

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Glenn Andrew Brottman, MDNPI 1205869740
Title
Owner
Phone
(212) 969-1899

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Prescribing (Medical) PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TP0016X 240287 NY
Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0800X 240287 NY Primary

Addresses

Primary practice location

119 West 57TH Street
Suite 1101
New York, NY 10019

Mailing address

119 West 57TH Street
Suite 1101
New York, NY 10019
Phone (212) 969-1899

National Provider Directory

National Provider Directory

Locations

119 W 57th St
Ste 1101
New York, NY 10019
Phone (212) 969-1899

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1222387200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1236124800000",
    "number": "1104076165",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "119 WEST 57TH STREET",
            "address_2": "SUITE 1101",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10019",
            "telephone_number": "212-969-1899",
            "fax_number": "212-969-1898"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "119 WEST 57TH STREET",
            "address_2": "SUITE 1101",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10019",
            "telephone_number": "212-969-1899",
            "fax_number": "212-969-1898"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GLENN A BROTTMAN MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-09-26",
        "last_updated": "2009-03-04",
        "status": "A",
        "authorized_official_last_name": "BROTTMAN",
        "authorized_official_first_name": "GLENN",
        "authorized_official_middle_name": "ANDREW",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "212-969-1899",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "103TP0016X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Prescribing (Medical)",
            "state": "NY",
            "license": "240287",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "240287",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.