Active NPI
Madeleine Glick, MS, RD, CDN
- Registered Dietitian
- Chatham, NY
National Provider Identifier
1730259391
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 000515-1
- Practice address
- 71 Loomis Rd
Chatham, NY 12037-9777 - Phone
- (518) 965-2074
- NPI assigned
- Nov 9, 2006
- Last updated
- Aug 19, 2009
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 000515-1 | NY | Primary |
Addresses
Primary practice location
71 Loomis Rd
Chatham, NY 12037-9777
Mailing address
71 Loomis Rd
Chatham, NY 12037-9777
Phone (518) 965-2074
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 000515-1 | NY | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Fay Nutrition | Dietitian, Registered | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163030400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1250640000000",
"number": "1730259391",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "71 LOOMIS RD",
"city": "CHATHAM",
"state": "NY",
"postal_code": "120379777",
"telephone_number": "518-965-2074"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "71 LOOMIS RD",
"city": "CHATHAM",
"state": "NY",
"postal_code": "120379777",
"telephone_number": "518-965-2074"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GLICK",
"first_name": "MADELEINE",
"name_prefix": "Ms.",
"credential": "MS, RD, CDN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-11-09",
"last_updated": "2009-08-19",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "NY",
"license": "000515-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chatham, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.