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General NPI Number Information
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NPI Number | 1174427439
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Entity Type | Organization
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Legal Business Name | GLEN COVE PODIATRY, PLLC
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Dates
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Enumeration Date | 10/07/2026
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Last Update Date | 10/07/2026
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Provider Practice Location Address
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Address Line | 70 GLEN ST STE 300
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City | GLEN COVE
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State | NY
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Zip | 11542-2858
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Country | US
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Telephone | 516-676-1116
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Fax |
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Provider Business Mailing Address
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Address Line | 70 GLEN ST STE 300
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City | GLEN COVE
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State | NY
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Zip | 11542-2858
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Country | US
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Telephone | 516-676-1116
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Fax |
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Authorized Official
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Title or Position | PODIATRIST
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Name | DR. RUBY GARDNER
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Credential | DPM
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Telephone | 310-801-7893
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number |
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License Number State | NULL
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Taxonomy #2
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Taxonomy Code | 213EP0504X
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Taxonomy Name | Public Medicine Podiatrist
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License Number |
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License Number State | NULL
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Taxonomy #3
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Taxonomy Code | 213EP1101X
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Taxonomy Name | Primary Podiatric Medicine Podiatrist
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License Number |
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License Number State | NULL
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Taxonomy #4
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Taxonomy Code | 213ER0200X
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Taxonomy Name | Radiology Podiatrist
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License Number |
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License Number State | NULL
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Taxonomy #5
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Taxonomy Code | 213ES0000X
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Taxonomy Name | Sports Medicine Podiatrist
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License Number |
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License Number State | NULL
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