MEDICARE: HELENA GLODOVA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	164W00000X	Licensed Practical Nurse	282926	NY
2	163W00000X	Registered Nurse	672863	NY

General Provider Information

NPI Number	:	1235387390
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HELENA GLODOVA

Provider Business Mailing Address
First Line	:	2003 AVENUE J
Second Line	:	APT # 4G
City	:	BROOKLYN
State	:	NY
Zip	:	11210-3646
Country	:	US
Telephone Number	:	718-252-0939
Fax Number	:

Provider Business Practice Location Address
First Line	:	2003 AVENUE J
Second Line	:	APT # 4G
City	:	BROOKLYN
State	:	NY
Zip	:	11210-3646
Country	:	US
Telephone Number	:	718-510-6007
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/03/2008
Last Update Date	:	07/16/2013

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Directions to “ HELENA GLODOVA ” Practice Location

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