Glen Culbertson, PH.D.

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

Practice address

41 Park Ave
Latham, NY 12110-4130

Phone

(518) 783-9884

NPI assigned

Jan 21, 2020

Sex

Male

Sole proprietor

Yes

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

Credentials

Doctor of Philosophy

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

{
    "created_epoch": "1579564800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579564800000",
    "number": "1639709405",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "41 PARK AVE",
            "city": "LATHAM",
            "state": "NY",
            "postal_code": "121104130",
            "telephone_number": "518-783-9884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "41 PARK AVE",
            "city": "LATHAM",
            "state": "NY",
            "postal_code": "121104130",
            "telephone_number": "518-783-9884"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CULBERTSON",
        "first_name": "GLEN",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-01-21",
        "last_updated": "2020-01-21",
        "certification_date": "2020-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tami S. Crisafulli, M.S. CCC/SLP
• Terasa Criscione, RD
• Emily Anne Cromwell
• Aimee Croteau
• CTP Newton Medical PC
• Mikayla Culnan, RN
• Eleanor Theresa Curley, M.S.ED.
• Mark David Cury, DMD
• CVS Albany LLC
• CVS Albany LLC

• Athletic Trainer in Latham, NY
• Providers in Latham, NY by specialty
• Athletic Trainer in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2020; 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.