Glenna Damasco, NP

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

F310371 Issued in NY

Practice address

75 Maiden LN FL 10
New York, NY 10038-4607

Phone

(917) 261-7370

NPI assigned

Apr 15, 2022

Last updated

Apr 15, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Ny Ketamine Medical Practice PLLC

  dba NY Ketamine Medical Practice

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • New York, NY
  • NPI 1073496402
  NPD

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

{
    "created_epoch": "1649980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649980800000",
    "number": "1780327049",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "678 HEWLETT ST",
            "city": "FRANKLIN SQUARE",
            "state": "NY",
            "postal_code": "110101832"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 MAIDEN LN FL 10",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100384607",
            "telephone_number": "917-261-7370"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAMASCO",
        "first_name": "GLENNA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-04-15",
        "last_updated": "2022-04-15",
        "certification_date": "2022-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "F310371",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John E. Dalzell, MA, LMSW, MA
• Tanuja Damani, M.D.
• Tara Damani, OD
• Lasya Damaraju
• Harold Damas
• Grace Damasco, MS, FNP-BC
• Yolanda Damasco, RN
• Christopher Damato, PSY.D.
• Kristen Erin Damato, LCSW
• Susannah Dambmann, M.A.

• Adult Health Nurse Practitioner in New York, NY
• Providers in New York, NY by specialty
• Adult Health Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2022; 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.