MEDICARE: DR. DAVID GLEITMAN D.P.M.

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	213EP1101X	Primary Podiatric Medicine Podiatrist	N003089-1	NY
2	213ES0103X	Foot & Ankle Surgery Podiatrist	N003089-1	NY
3	213ES0131X	Foot Surgery Podiatrist	N003089-1	NY

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	480014449	OTHER	NY	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	P501232	OTHER	NY	OXFORD
3	P3374	OTHER	NY	BLUE CROSS BLUE SHIELD
4	55225	OTHER	NY	GHI
5	P0030891	OTHER	NY	WORKERS COMPENSATION
6	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
7	100023086701	OTHER	NY	UNITED HEALTHCARE

General Provider Information

NPI Number	:	1790840486
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DAVID GLEITMAN D.P.M.

Provider Business Mailing Address
First Line	:	1532 FLATBUSH AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11210-2427
Country	:	US
Telephone Number	:	718-434-0007
Fax Number	:	718-434-0965

Provider Business Practice Location Address
First Line	:	1532 FLATBUSH AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11210-2427
Country	:	US
Telephone Number	:	718-434-0007
Fax Number	:	718-434-0965

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

Provider Enumeration Date	:	12/24/2006
Last Update Date	:	12/14/2012

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