Healthcare Provider Details

I. General information

NPI: 1912811027
Provider Name (Legal Business Name): ELIZABETH A GLOEGGLER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ELIZABETH A DRESCHER

II. Dates (important events)

Enumeration Date: 09/28/2026
Last Update Date: 09/28/2026
Certification Date: 09/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

99 CENTRAL AVE
AMITYVILLE NY
11701-3537
US

IV. Provider business mailing address

99 CENTRAL AVE
AMITYVILLE NY
11701-3537
US

V. Phone/Fax

Practice location:
  • Phone: 516-317-9284
  • Fax:
Mailing address:
  • Phone: 516-317-9284
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number1971313251
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: