Gleen Bautista Anciro, PT,DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

023716 Issued in NY

Practice address

769 58TH St Ste 1
Brooklyn, NY 11220-5180

Phone

(347) 889-5889

Fax

(347) 889-5873

NPI assigned

Mar 27, 2008

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Greenland Physical Therapy PC

  • Physical Therapist
  • Bay Shore, NY
  • NPI 1528669173
  NPD Authorized official
• East & West Physical Therapist & Acupuncture PLLC

  • Physical Therapist
  • Brooklyn, NY
  • NPI 1750828547
  NPD (past)

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

{
    "created_epoch": "1206576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621900800000",
    "number": "1174795314",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 21089",
            "city": "FLORAL PARK",
            "state": "NY",
            "postal_code": "110021089",
            "telephone_number": "516-270-3673",
            "fax_number": "516-270-3673"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "769 58TH ST STE 1",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112205180",
            "telephone_number": "347-889-5889",
            "fax_number": "347-889-5873"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2041 86th St # C1",
            "address_purpose": "LOCATION",
            "city": "Brooklyn",
            "state": "NY",
            "postal_code": "112143203",
            "country_code": "US",
            "telephone_number": "347-889-5889",
            "fax_number": "347-889-5873",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ANCIRO",
        "first_name": "GLEEN",
        "middle_name": "BAUTISTA",
        "name_prefix": "Ms.",
        "credential": "PT,DPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-03-27",
        "last_updated": "2021-05-25",
        "certification_date": "2021-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "023716",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anchora Care NJ LLC
• Ancient & Modern Acupuncture P.C.
• Ancient Song Doula Services
• Ancient Wisdom of Acupuncture P.C.
• Jean Herold Ancion, M.D.
• Ancona Eyecare Inc
• Robert J Ancona, O.D.
• Melsha Ancrum
• Abraham Ancselovics, DDS
• Iman Andalib, M.D.

• Physical Therapist in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• Physical Therapist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2021; 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.