Provider Demographics
NPI:1003066531
Name:GLASPER, RYANNE TANAE (PT)
Entity Type:Individual
Prefix:
First Name:RYANNE
Middle Name:TANAE
Last Name:GLASPER
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:171 JEFFERSON AVE APT 2
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11216-1610
Mailing Address - Country:US
Mailing Address - Phone:602-501-1809
Mailing Address - Fax:
Practice Address - Street 1:230 W 38TH ST FL 18
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10018-9048
Practice Address - Country:US
Practice Address - Phone:212-997-7490
Practice Address - Fax:212-007-7492
Is Sole Proprietor?:No
Enumeration Date:2008-09-20
Last Update Date:2009-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYPP66003225100000X
NY62031062225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist