MEDICARE: GLASS AND POMERANTZ, MD'S, PLLC

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	207NS0135X	Procedural Dermatology Physician	146474	NY

General Provider Information

NPI Number	:	1467659904
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GLASS AND POMERANTZ, MD'S, PLLC

Provider Business Mailing Address
First Line	:	271 DOUGHTY BLVD
Second Line	:
City	:	INWOOD
State	:	NY
Zip	:	11096-2135
Country	:	US
Telephone Number	:	516-239-4244
Fax Number	:	516-371-6083

Provider Business Practice Location Address
First Line	:	265 W PARK AVE
Second Line	:
City	:	LONG BEACH
State	:	NY
Zip	:	11561-3222
Country	:	US
Telephone Number	:	516-239-4244
Fax Number	:	516-371-6083

Authorized Official
Title or Position	:	OFFICE MANAGER
Name	:	WENDY J WEINER
Credential	:
Telephone Number	:	914-347-8711

Provider Enumeration Date	:	06/28/2007
Last Update Date	:	08/22/2020

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