Glenne Glassberg, RDN

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

86066215 Issued in NY

Practice address

1094 Fulton St
Woodmere, NY 11598

Phone

(570) 878-3642

NPI assigned

Jun 19, 2018

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other identifiers 1

Other names 1

• Gila Polatoff Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1529366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1573171200000",
    "number": "1457845851",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "960 W BROADWAY",
            "city": "WOODMERE",
            "state": "NY",
            "postal_code": "115981647",
            "telephone_number": "570-878-3642"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1094 FULTON ST",
            "city": "WOODMERE",
            "state": "NY",
            "postal_code": "11598",
            "telephone_number": "570-878-3642"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLASSBERG",
        "first_name": "GLENNE",
        "credential": "RDN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-06-19",
        "last_updated": "2019-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133VN1004X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered, Nutrition, Pediatric",
            "state": "NY",
            "license": "86066215",
            "primary": false
        },
        {
            "code": "133VN1005X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered, Nutrition, Renal",
            "state": "NY",
            "license": "86066215",
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "NY",
            "license": "86066215",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "86066215",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "GILA",
            "last_name": "POLATOFF",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Joan A Gelfman, LCSW
• Genovese Drug Stores Inc (Rite Aid Pharmacy 10622)
• Esther Gerson
• Natasha Ann Gillie
• Renee Girardi
• Lori Ann Glatt
• Michelle Glatt, FNP
• Alisa Glickman
• Amanda Gluck, M.S.
• Helene Sylvia Goldberg, CRC

• Registered Dietitian in Woodmere, NY
• Providers in Woodmere, NY by specialty
• Registered Dietitian in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2019; 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.