Glenn C. Ellenbogen

Primary specialty

SpecialistTaxonomy code 174400000X

Practice address

460 W 34TH St
11TH Floor
New York, NY 10001-2320

Phone

(212) 273-6519

NPI assigned

Dec 26, 2006

Sex

Male

Sole proprietor

No

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

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1167091200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1318982400000",
    "number": "1285799775",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "630 1ST AVE",
            "address_2": "APT 32P",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100163700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "460 W 34TH ST",
            "address_2": "11TH FLOOR",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100012320",
            "telephone_number": "212-273-6519"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLENBOGEN",
        "first_name": "GLENN",
        "middle_name": "C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-26",
        "last_updated": "2011-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jack Ellenberg, MD
• Leah Rachel Ellenberg, O.D.
• Luke Grisha Ellenberg, C.A.S.A.C.
• Amy Abigail Ellenbogen, M.S.W.
• Donna Elise Ellenbogen
• Nicole Danielle Ellenbogen
• Lora Ellenson, M.D.
• Alexandra Eller
• Christina Eller, LMHC MSED
• Melinda Eller, PA-C

• Specialist in New York, NY
• Providers in New York, NY by specialty
• Specialist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 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.