Active NPI
Joel Gluck
- Dentist
- New Hyde Park, NY
National Provider Identifier
1750785796
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 021878
- Practice address
- 700 Hillside Ave
New Hyde Park, NY 11040-2531 - Phone
- (516) 352-2445
- Fax
- (516) 352-2855
- NPI assigned
- Oct 20, 2014
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Dentist | 122300000X | 021878 | NY | Primary |
Addresses
Primary practice location
700 Hillside Ave
New Hyde Park, NY 11040-2531
Mailing address
700 Hillside Avenue
New Hyde Park, NY 11758
Phone (516) 352-2445
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 021878 | NY | MD | Developmental Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1413763200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1413763200000",
"number": "1750785796",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "700 HILLSIDE AVENUE",
"city": "NEW HYDE PARK",
"state": "NY",
"postal_code": "11758",
"telephone_number": "516-352-2445",
"fax_number": "516-352-2855"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "700 HILLSIDE AVE",
"city": "NEW HYDE PARK",
"state": "NY",
"postal_code": "110402531",
"telephone_number": "516-352-2445",
"fax_number": "516-352-2855"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GLUCK",
"first_name": "JOEL",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2014-10-20",
"last_updated": "2014-10-20",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "NY",
"license": "021878",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New Hyde Park, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.