Organization Active NPI

Glendale Medical Associates PC

  • Family Medicine Physician
  • Glendale, NY
National Provider Identifier
1972666352
Registry record updated Dec 5, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
GLENDALE MEDICAL ASSOCIATES PC
Practice address
7401 Myrtile Ave
Glendale, NY 11385-7433
Phone
(718) 821-5500
Fax
(718) 456-0778
NPI assigned
Dec 18, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2007

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

Authorized official

Name
Ronald Langman
Title
Owner
Phone
(718) 821-5500

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

7401 Myrtile Ave
Glendale, NY 11385-7433

Mailing address

7401 Myrtile Ave
Glendale, NY 11385-7433
Phone (718) 821-5500

Other identifiers 1

IdentifierTypeStateIssuer
01579304MedicaidNY

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1166400000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1196812800000",
    "number": "1972666352",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7401 MYRTILE AVE",
            "city": "GLENDALE",
            "state": "NY",
            "postal_code": "113857433",
            "telephone_number": "718-821-5500",
            "fax_number": "718-456-0778"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7401 MYRTILE AVE",
            "city": "GLENDALE",
            "state": "NY",
            "postal_code": "113857433",
            "telephone_number": "718-821-5500",
            "fax_number": "718-456-0778"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GLENDALE MEDICAL ASSOCIATES PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-18",
        "last_updated": "2007-12-05",
        "status": "A",
        "authorized_official_last_name": "LANGMAN",
        "authorized_official_first_name": "RONALD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "718-821-5500"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01579304",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 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.

Verify at the official NPI Registry.