Madison Kathryn Gluck, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

045162 Issued in NY

Practice address

101 Dates Dr
Ithaca, NY 14850-1383

Phone

(607) 274-4011

NPI assigned

Jan 8, 2020

Sex

Female

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)

Not enrolled

State licenses

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

{
    "created_epoch": "1578441600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615075200000",
    "number": "1467092452",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 DATES DR",
            "city": "ITHACA",
            "state": "NY",
            "postal_code": "148501383",
            "telephone_number": "607-274-4011",
            "fax_number": "607-795-8017"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 DATES DR",
            "city": "ITHACA",
            "state": "NY",
            "postal_code": "148501383",
            "telephone_number": "607-274-4011"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "555 Saint Josephs Blvd",
            "address_purpose": "LOCATION",
            "city": "Elmira",
            "state": "NY",
            "postal_code": "149013256",
            "country_code": "US",
            "telephone_number": "607-737-7804 x2550",
            "fax_number": "607-795-8017",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GLUCK",
        "first_name": "MADISON",
        "middle_name": "KATHRYN",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-01-08",
        "last_updated": "2021-03-07",
        "certification_date": "2021-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "045162",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Karen Dashiff Gilovich, M.S., L.C.S.W.
• Mary Gitlin, RN
• Marc Gittelson, RN
• Cindy Lee Glanville
• Betty Jean Gloss
• Sarah Godlewski, LPC, LMHC-D
• Brianna Goldbeck
• Laureen Golden, LCSW
• Sherry S Golden, M.S.
• Anna Golding

• Physical Therapist in Ithaca, NY
• Providers in Ithaca, 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 Mar 7, 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.