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General NPI Number Information
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NPI Number | 1639236854
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Entity Type | Organization
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Legal Business Name | GLENRIDGE MEDICAL ASSOCIATES PC
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Dates
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Enumeration Date | 01/03/2007
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 385 SENECA AVE
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City | RIDGEWOOD
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State | NY
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Zip | 11385-1340
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Country | US
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Telephone | 718-821-1222
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Fax |
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Provider Business Mailing Address
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Address Line | 385 SENECA AVE
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City | RIDGEWOOD
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State | NY
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Zip | 11385-1340
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Country | US
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Telephone | 718-821-1222
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. DEEPAK SETIA
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Credential | MD
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Telephone | 718-821-1222
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 132693
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 207RG0300X
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Taxonomy Name | Geriatric Medicine (Internal Medicine) Physician
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License Number | 218001
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 231211
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License Number State | NY
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