MEDICARE: DR. DOINA LAURA GLODAN MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RG0300X	Geriatric Medicine (Internal Medicine) Physician	227615	NY

General Provider Information

NPI Number	:	1588646871
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DOINA LAURA GLODAN MD

Provider Business Mailing Address
First Line	:	100 PORT WASHINGTON BLVD
Second Line	:
City	:	ROSLYN
State	:	NY
Zip	:	11576-1347
Country	:	US
Telephone Number	:	516-562-6385
Fax Number	:	516-562-6300

Provider Business Practice Location Address
First Line	:	100 PORT WASHINGTON BLVD
Second Line	:
City	:	ROSLYN
State	:	NY
Zip	:	11576-1347
Country	:	US
Telephone Number	:	516-562-6385
Fax Number	:	516-562-6300

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/14/2005
Last Update Date	:	11/22/2011

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