MEDICARE: MS. ANNMARIE GLENN MS, OTR

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	225XP0200X	Pediatric Occupational Therapist	010675-1	NY
2	225XP0200X	Pediatric Occupational Therapist	OT22251	FL

Other Identifiers

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

General Provider Information

NPI Number	:	1982800025
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. ANNMARIE GLENN MS, OTR

Provider Business Mailing Address
First Line	:	2236 N CYPRESS BEND DR APT 512
Second Line	:
City	:	POMPANO BEACH
State	:	FL
Zip	:	33069-5613
Country	:	US
Telephone Number	:	845-594-4478
Fax Number	:

Provider Business Practice Location Address
First Line	:	2236 N CYPRESS BEND DR APT 512
Second Line	:
City	:	POMPANO BEACH
State	:	FL
Zip	:	33069-5613
Country	:	US
Telephone Number	:	845-594-4478
Fax Number	:

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

Provider Enumeration Date	:	06/25/2007
Last Update Date	:	02/24/2022

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