Active NPI
Joseph P Glenmullen, MD
- Neurology Physician
- Cambridge, MA
National Provider Identifier
1841383395
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neurology Physician
- License
- 54871
- Practice address
- 75 Mt. Auburn St.
Cambridge, MA 02138 - Phone
- (617) 496-9506
- NPI assigned
- Oct 2, 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 |
|---|---|---|---|---|
| Neurology Physician | 2084N0400X | 54871 | MA | Primary |
Addresses
Primary practice location
75 Mt. Auburn St.
Cambridge, MA 02138
Mailing address
168 Lexington Avenue
Cambridge, MA 02138
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 |
|---|---|---|---|
| 54871 | MA | MD | Neurology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159747200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1841383395",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "168 LEXINGTON AVENUE",
"city": "CAMBRIDGE",
"state": "MA",
"postal_code": "02138"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "75 MT. AUBURN ST.",
"city": "CAMBRIDGE",
"state": "MA",
"postal_code": "02138",
"telephone_number": "617-496-9506"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GLENMULLEN",
"first_name": "JOSEPH",
"middle_name": "P",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-02",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "2084N0400X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Neurology",
"state": "MA",
"license": "54871",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cambridge, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.