Glenwood Medical PC

Primary specialty

Neuromuscular Medicine (Psychiatry & Neurology) PhysicianTaxonomy code 2084N0008X

License

192310 Issued in NY

Legal business name

GLENWOOD MEDICAL PC

Doing business as

Glenwood Medical Neuro Rehab

Practice address

11572 Francis Lewis Blvd
Cambria Heights, NY 11411-1028

Phone

(718) 276-8666

Fax

(718) 276-4158

NPI assigned

Nov 28, 2011

Last updated

Nov 28, 2011By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Osafradu OpamNPI 1134289499

Title

MD

Phone

(718) 276-8666

Specialties & licenses 1

Addresses

Other names 1

• Glenwood Medical Neuro Rehab Doing business as

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Osafradu Opam

  • Internal Medicine Physician
  • Jamaica, NY
  • NPI 1134289499
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1322438400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1322438400000",
    "number": "1518234145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11572 FRANCIS LEWIS BLVD",
            "city": "CAMBRIA HEIGHTS",
            "state": "NY",
            "postal_code": "114111028",
            "telephone_number": "718-276-8666",
            "fax_number": "718-276-4158"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11572 FRANCIS LEWIS BLVD",
            "city": "CAMBRIA HEIGHTS",
            "state": "NY",
            "postal_code": "114111028",
            "telephone_number": "718-276-8666",
            "fax_number": "718-276-4158"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GLENWOOD MEDICAL PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-11-28",
        "last_updated": "2011-11-28",
        "status": "A",
        "authorized_official_last_name": "OPAM",
        "authorized_official_first_name": "OSAFRADU",
        "authorized_official_title_or_position": "MD",
        "authorized_official_telephone_number": "718-276-8666"
    },
    "taxonomies": [
        {
            "code": "2084N0008X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neuromuscular Medicine",
            "state": "NY",
            "license": "192310",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Glenwood Medical Neuro Rehab",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Luis Gaston, RPA-C
• Desiree Gebon
• Yeshika George, OTR/L
• Allesia Sandrina Gibson, RN
• Ednie Gilles
• GMD Logistics
• Milthy Gomez-Oligbo
• Sharon Gordon
• Nermalyn Grandison
• Lisa E Graubart, LCSW

• Neuromuscular Medicine (Psychiatry & Neurology) Physician in Cambria Heights, NY
• Providers in Cambria Heights, NY by specialty
• Neuromuscular Medicine (Psychiatry & Neurology) Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.