Glen E Marin, D.O.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

162617-1 Issued in NY

Practice address

21422 73Rd Ave
Oakland Gardens, NY 11364-2914

Phone

(718) 464-4444

Fax

(718) 465-1888

NPI assigned

Sep 21, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Murray Hill Podiatric Associates LLP

  • Foot Surgery Podiatrist
  • New York, NY
  • NPI 1114107315
  NPD (past)

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

{
    "created_epoch": "1158796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1214524800000",
    "number": "1700985231",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21422 73RD AVE",
            "city": "OAKLAND GARDENS",
            "state": "NY",
            "postal_code": "113642914",
            "telephone_number": "718-464-4444",
            "fax_number": "718-465-1888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21422 73RD AVE",
            "city": "OAKLAND GARDENS",
            "state": "NY",
            "postal_code": "113642914",
            "telephone_number": "718-464-4444",
            "fax_number": "718-465-1888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARIN",
        "first_name": "GLEN",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-21",
        "last_updated": "2008-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "162617-1",
            "primary": true
        },
        {
            "code": "207QG0300X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": "NY",
            "license": "162617-1",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Niha Abhyankar Malcomson
• Sandra Mandel, M.D.
• Alice M Mann, O.D.
• Dennis Mann, DC
• Tricia Ann Margarone, RN
• Brianna Archer McCann
• Daniel Melore, LCSWR
• Nargis Memon, PT
• Stanley X Meng
• Victoria Mignone

• Family Medicine Physician in Oakland Gardens, NY
• Providers in Oakland Gardens, NY by specialty
• Family Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2008; 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.