Glen Alan Colodny, D.C., R.D.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

X005814 Issued in NY

Practice address

226 Burns St
Forest Hills, NY 11375-6130

Phone

(917) 435-2893

Fax

(718) 268-3598

NPI assigned

Dec 29, 2011

Last updated

Dec 29, 2011By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

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.

{
    "created_epoch": "1325116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1325116800000",
    "number": "1154690618",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "226 BURNS ST",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113756130",
            "telephone_number": "917-435-2893",
            "fax_number": "718-268-3598"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "226 BURNS ST",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113756130",
            "telephone_number": "917-435-2893",
            "fax_number": "718-268-3598"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLODNY",
        "first_name": "GLEN",
        "middle_name": "ALAN",
        "name_prefix": "Dr.",
        "credential": "D.C., R.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-12-29",
        "last_updated": "2011-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NY",
            "license": "X005814",
            "primary": true
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "NY",
            "license": "960913",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Samantha Collins
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• Chiropractor in Forest Hills, NY
• Providers in Forest Hills, NY by specialty
• Chiropractor in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2011; 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.