MEDICARE: ANNA GLUSHETS

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	174400000X	Specialist	2189242	NY

General Provider Information

NPI Number	:	1487917662
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANNA GLUSHETS

Provider Business Mailing Address
First Line	:	2415 QUEENS PLZ N
Second Line	:	5A
City	:	LONG ISLAND CITY
State	:	NY
Zip	:	11101-4019
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2415 QUEENS PLZ N
Second Line	:	5A
City	:	LONG ISLAND CITY
State	:	NY
Zip	:	11101-4019
Country	:	US
Telephone Number	:	347-614-9600
Fax Number	:

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

Provider Enumeration Date	:	06/21/2012
Last Update Date	:	06/21/2012

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Directions to “ ANNA GLUSHETS ” Practice Location

Language	Start Address	Practice Location

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