Glendroy Michael McMillan

Primary specialty

Case Manager/Care CoordinatorTaxonomy code 171M00000X

Practice address

91-14 Merrick Blvd 6TH FL.
Jamaica, NY 11432

Phone

(201) 839-6693

NPI assigned

Nov 25, 2024

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

Other names 1

• Mr. Glen McMillan Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1732492800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732492800000",
    "number": "1316763295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "91-14 MERRICK BLVD 6TH FL.",
            "city": "JAMAICA",
            "state": "NY",
            "postal_code": "11432"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "91-14 MERRICK BLVD 6TH FL.",
            "city": "JAMAICA",
            "state": "NY",
            "postal_code": "11432",
            "telephone_number": "201-839-6693"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCMILLAN",
        "first_name": "GLENDROY",
        "middle_name": "MICHAEL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-11-25",
        "last_updated": "2024-11-25",
        "certification_date": "2024-11-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "GLEN",
            "last_name": "MCMILLAN",
            "prefix": "MR.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Marlon McLeod, MD
• Judith McLetchie
• Jenna Lynn McLoughlin, LMSW
• Dennis E McMillan
• George Alfred McMillan, M.D.
• Lynn McMillan
• Michelle Maxine McMillan
• Kerrod Dwayne McNeal, PA-C
• Sheila McNeil
• Dianne McNeshie, LPN

• Case Manager/Care Coordinator in Jamaica, NY
• Providers in Jamaica, NY by specialty
• Case Manager/Care Coordinator in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2024; 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.