NPIMap

Organization Active NPI

Glenwood Podiatry PC

  • Podiatrist
  • Glendale, NY
National Provider Identifier
1972938512
Registry record updated Nov 7, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
N004970 Issued in NY
Legal business name
GLENWOOD PODIATRY PC
Practice address
6216 Myrtle Ave
Glendale, NY 11385-6236
Phone
(718) 821-2161
Fax
(718) 821-1252
NPI assigned
Sep 12, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 7, 2013

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

Authorized official

Name
Dr. Jeffrey H Stark, D.P.M.NPI 1124112255
Title
President
Phone
(718) 821-2161

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213E00000X N004970 NY Primary

Addresses

Primary practice location

6216 Myrtle Ave
Glendale, NY 11385-6236

Mailing address

6216 Myrtle Ave
Glendale, NY 11385-6236
Phone (718) 821-2161

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": "1378944000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1383782400000",
    "number": "1972938512",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6216 MYRTLE AVE",
            "city": "GLENDALE",
            "state": "NY",
            "postal_code": "113856236",
            "telephone_number": "718-821-2161",
            "fax_number": "718-821-1252"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6216 MYRTLE AVE",
            "city": "GLENDALE",
            "state": "NY",
            "postal_code": "113856236",
            "telephone_number": "718-821-2161",
            "fax_number": "718-821-1252"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GLENWOOD PODIATRY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-09-12",
        "last_updated": "2013-11-07",
        "status": "A",
        "authorized_official_last_name": "STARK",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "718-821-2161",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.P.M."
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist",
            "state": "NY",
            "license": "N004970",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Nov 7, 2013; 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.