Earl Gordon Glucksman, P.T.

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

6121 Issued in NY

Practice address

1 Marcy CT
Setauket, NY 11733-1942

Phone

(631) 689-1678

Fax

(631) 689-1678

NPI assigned

Dec 22, 2009

Sex

Male

Sole proprietor

Yes

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Dec 22, 2009.

{
    "created_epoch": "1261440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1261440000000",
    "number": "1104155100",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 MARCY CT",
            "city": "SETAUKET",
            "state": "NY",
            "postal_code": "117331942",
            "telephone_number": "631-689-1678",
            "fax_number": "631-689-1678"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 MARCY CT",
            "city": "SETAUKET",
            "state": "NY",
            "postal_code": "117331942",
            "telephone_number": "631-689-1678",
            "fax_number": "631-689-1678"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLUCKSMAN",
        "first_name": "EARL",
        "middle_name": "GORDON",
        "name_prefix": "Mr.",
        "credential": "P.T.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-12-22",
        "last_updated": "2009-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "6121",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• All providers in Setauket, NY
• Physical Therapist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 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.