GLEN ANDERSON (NPI# 1801061288) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1801061288 |
| Entity Type | Individual |
| Full Name | GLEN ANDERSON |
| Credential | RPA-C |
| Practice Address |
3767 Main Street Warrensburg NY 12885-1890 |
| Mailing Address |
9 Carey Rd Queensbury NY 12804-7880 |
| Practice Telephone | 5186232844 |
| Practice Fax Number | 5186233416 |
| Mailing Telephone | 5187610300 |
| Mailing Fax Number | 5188242388 |
| Enumeration Date | 2008-04-25 |
| Last Update Date | 2017-02-02 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
005207 | NY | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | 02346541 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760855704 | Glen Anderson | Pharmacist | 31 Tennis Village Dr, Heath, TX 75032-5995 | 2015-11-12 |
| 1346369808 | Glen Wayne Anderson Jr. | Psychologist | 1650 Greenfield St, Wilmington, NC 28401-6456 | 2007-03-28 |
| 1245268366 | Glen Davis Anderson | Nurse Anesthetist, Certified Registered | 1 Medical Center Dr, Lebanon, NH 03756-1000 | 2006-06-29 |
| 1124089677 | Glen F Anderson | Surgery | 2530 Chicago Ave, #550, Minneapolis, MN 55404-4289 | 2006-03-31 |
| Street Address |
3767 MAIN STREET |
| City | WARRENSBURG |
| State | NY |
| Zip Code | 12885-1890 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033112743 | James F Morrissey | Internal Medicine | 3767 Main Street, Warrensburg, NY 12885-1890 | 2005-05-27 |
| 1568941532 | Olivia Mae Maxam | Nurse Practitioner | 3767 Main Street, Warrensburg, NY 12885-1890 | 2018-08-10 |
| 1235476532 | Rosemary T Vassallo | Social Worker | 3767 Main Street, Warrensburg, NY 12885-1890 | 2013-01-08 |
| 1114296100 | Holly S Spire | Social Worker | 3767 Main Street, Warrensburg, NY 12885-1890 | 2011-12-20 |
| 1356584072 | Julie Lynn Fisher | Social Worker | 3767 Main Street, Warrensburg, NY 12885-1890 | 2009-04-10 |
| 1316196462 | James F Hindson | Internal Medicine | 3767 Main Street, Warrensburg, NY 12885-1890 | 2008-09-13 |
| 1447390976 | Lisa M Woolfe | Social Worker | 3767 Main Street, Warrensburg, NY 12885-1890 | 2007-02-07 |
| 1134118821 | Michael Randolph Bell | Family Medicine | 3767 Main Street, Warrensburg, NY 12885-1890 | 2005-10-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477636462 | Raluca Sandler | Dentist | 3814 Main Street, Warrensburg, NY 12885 | 2006-10-23 |
| 1326144072 | Warrensburg Emergency Medical Services Inc | Ambulance | 3 King St, Warrensburg, NY 12885 | 2006-09-16 |
| 1396118642 | Tia Dawson | Social Worker | 1 James St, Warrensburg, NY 12885 | 2015-11-09 |
| 1912281502 | Rita L Navatka | Social Worker | 3767 Main St, Warrensburg, NY 12885 | 2011-09-30 |
| 1902099450 | Jeanine R Lawler | Specialist | 28 Lake Ave, Warrensburg, NY 12885-1028 | 2007-08-18 |
| 1790098747 | Joann Elizabeth Donohue | Registered Nurse | 11 Ashe Dr, Warrensburg, NY 12885-1032 | 2010-07-20 |
| 1598190688 | Suzanne Sheree Walpole | Pharmacist | 3971 Main St, Warrensburg, NY 12885-1152 | 2013-09-07 |
| 1760412225 | Wendy Ann Maciariello | Physical Therapist | 28 Hudson St, Warrensburg, NY 12885-1204 | 2006-07-03 |
| 1942607197 | Tara Brown | Physical Therapist | 28 Hudson St, Warrensburg, NY 12885-1204 | 2014-12-03 |
| 1427481845 | Erica Ovitt Mahoney | Physical Therapist | 28 Hudson St, Warrensburg, NY 12885-1204 | 2013-08-21 |
| Find all providers in zip 12885 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487252581 | North Shore Medical Group Pllc | Physician Assistant | 311 Skyview Ter, Syracuse, NY 13219-2835 | 2020-10-12 |
| 1477169654 | Kristen Ariel O'connell | Physician Assistant | 85 John St Apt 7a, New York, NY 10038-2844 | 2020-09-22 |
| 1699381616 | David Nmn Kao | Physician Assistant | 737 Pleasant Avenue, Westbury, NY 11590-6407 | 2020-09-16 |
| 1043824816 | Elizabeth Keane | Physician Assistant | 25 Hollis Dr, Sound Beach, NY 11789-1629 | 2020-08-31 |
| 1497364111 | Tianna Stephens | Physician Assistant | 165 N Village Ave Ste 5, Rockville Centre, NY 11570-3701 | 2020-07-28 |
| 1124636188 | Shannon Maureen O'connell | Physician Assistant | 270-05 270th Ave, New Hyde Park, NY 11040 | 2020-07-16 |
| 1841818895 | Yanick Dugue | Physician Assistant | 4 Lincoln Ave, New Hyde Park, NY 11040-3125 | 2020-07-07 |
| 1194340505 | Kayleigh Marie Tourt | Physician Assistant | 222 Alexander St Fl 4, Rochester, NY 14607-4039 | 2020-06-11 |
| 1023638509 | Kristina Rajic | Physician Assistant | 7237 66th Dr, Flushing, NY 11379-2111 | 2020-04-24 |
| 1114547791 | Michele Hein | Physician Assistant | 700 Veterans Memorial Hwy, Hauppauge, NY 11788-2952 | 2020-04-23 |
| Find all providers with the same taxonomy | ||||
| City | WARRENSBURG |
| Zip Code | 12885 |
Please comment or provide details below to improve the information on GLEN ANDERSON.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.