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NPI Code Detail

MEDICARE: GLENRIDGE MEDICAL ASSOCIATES PC

MEDICARE: GLENRIDGE MEDICAL ASSOCIATES PC
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
1207R00000XInternal Medicine Physician132693NY
2207RG0300XGeriatric Medicine (Internal Medicine) Physician218001NY
3207R00000XInternal Medicine Physician231211NY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1639236854
Entity Type Code : Organization
Provider Name (Legal Business Name) : GLENRIDGE MEDICAL ASSOCIATES PC
Provider Business Mailing Address
First Line : 385 SENECA AVE
Second Line :
City : RIDGEWOOD
State : NY
Zip : 11385-1340
Country : US
Telephone Number : 718-821-1222
Fax Number :
Provider Business Practice Location Address
First Line : 385 SENECA AVE
Second Line :
City : RIDGEWOOD
State : NY
Zip : 11385-1340
Country : US
Telephone Number : 718-821-1222
Fax Number :
Authorized Official
Title or Position : PRESIDENT
Name : DR. DEEPAK SETIA
Credential : MD
Telephone Number : 718-821-1222
Provider Enumeration Date : 01/03/2007
Last Update Date : 09/11/2025

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Directions to “GLENRIDGE MEDICAL ASSOCIATES PC ” Practice Location

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