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General NPI Number Information
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NPI Number | 1730631383
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Entity Type | Individual
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Provider Name | HEATHER GLUBO PHD
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Gender | Female
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Dates
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Enumeration Date | 10/31/2016
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Last Update Date | 10/31/2016
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Provider Practice Location Address
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Address Line | 136 E 57TH ST #1101
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City | NEW YORK
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State | NY
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Zip | 10022-2707
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Country | US
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Telephone | 201-926-5313
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Fax |
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Provider Business Mailing Address
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Address Line | 180 MYRTLE AVE 4F
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City | BROOKLYN
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State | NY
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Zip | 11201-3020
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Country | US
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Telephone | 201-926-5313
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TB0200X
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Taxonomy Name | Cognitive & Behavioral Psychologist
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License Number | 020585
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License Number State | NY
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