Angela M Gliatta

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

20601 Issued in CA

Practice address

30 Broad St
45TH Floor
New York, NY 10004-2304

Phone

(212) 530-0630

Fax

(212) 867-4353

NPI assigned

Oct 13, 2009

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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

{
    "created_epoch": "1255392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705449600000",
    "number": "1801121561",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 BROAD ST",
            "address_2": "45TH FLOOR",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100042304",
            "telephone_number": "212-530-0630",
            "fax_number": "212-867-4353"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 BROAD ST",
            "address_2": "45TH FLOOR",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100042304",
            "telephone_number": "212-530-0630",
            "fax_number": "212-867-4353"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLIATTA",
        "first_name": "ANGELA",
        "middle_name": "M",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-10-13",
        "last_updated": "2024-01-17",
        "certification_date": "2024-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MA",
            "license": "PA5133",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "017370",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "20601",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kayla Glerum
• Marshall Jay Glesby, M.D.
• Shannon Glessner, RN
• Mikhail Gleyzer, D.O.
• Ilya G Glezerman, MD
• Peter M Gliatto, MD
• Glick Dental Associate PLLC
• Alexander F Glick, M.D.
• Anna Glick, D.D.S.
• Isabel Glick

• Physician Assistant in New York, NY
• Providers in New York, NY by specialty
• Physician Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.