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General NPI Number Information
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NPI Number | 1306284930
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Entity Type | Organization
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Legal Business Name | RESTORATIVE MEDICINE, P.C.
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Dates
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Enumeration Date | 06/05/2013
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Last Update Date | 03/23/2022
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Provider Practice Location Address
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Address Line | 77 PONDFIELD RD # GFL2
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City | BRONXVILLE
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State | NY
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Zip | 10708-3809
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Country | US
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Telephone | 914-752-7797
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Fax | 844-854-7503
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Provider Business Mailing Address
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Address Line | 192 BON AIR AVE
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City | NEW ROCHELLE
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State | NY
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Zip | 10804-3105
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Country | US
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Telephone | 914-752-7797
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Fax | 844-854-7503
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Authorized Official
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Title or Position | OWNER
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Name | DR. JUDITH ANN GLASER
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Credential | D.O.
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Telephone | 516-327-9777
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | 248529
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License Number State | NY
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