Active NPI
Glenn Reginald Jeffery, MD
- Psychiatry Physician
- New York, NY
National Provider Identifier
1841381373
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 187649
- Practice address
- 25 Allen Street
Lower East Side Harm Reduction Center
New York, NY 10002 - Phone
- (212) 266-6333
- Fax
- (212) 343-8005
- NPI assigned
- Sep 28, 2006
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 187649 | NY | Primary |
Addresses
Primary practice location
25 Allen Street
Lower East Side Harm Reduction Center
New York, NY 10002
Mailing address
25 Allen Street
Lower East Side Harm Reduction Center
New York, NY 10002
Phone (212) 266-6333
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00246075 | Medicaid | NY |
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 187649 | NY | MD | Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159401600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1458518400000",
"number": "1841381373",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "25 ALLEN STREET",
"address_2": "LOWER EAST SIDE HARM REDUCTION CENTER",
"city": "NEW YORK",
"state": "NY",
"postal_code": "10002",
"telephone_number": "212-266-6333",
"fax_number": "212-343-8005"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "25 ALLEN STREET",
"address_2": "LOWER EAST SIDE HARM REDUCTION CENTER",
"city": "NEW YORK",
"state": "NY",
"postal_code": "10002",
"telephone_number": "212-266-6333",
"fax_number": "212-343-8005"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JEFFERY",
"first_name": "GLENN",
"middle_name": "REGINALD",
"name_prefix": "Mr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-09-28",
"last_updated": "2016-03-21",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "NY",
"license": "187649",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00246075",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.