Provider Demographics
NPI:1013371434
Name:PERRY, GLAUCIA
Entity Type:Individual
Prefix:MRS
First Name:GLAUCIA
Middle Name:
Last Name:PERRY
Suffix:
Gender:F
Credentials:
Other - Prefix:MISS
Other - First Name:HADASSA
Other - Middle Name:
Other - Last Name:AVRAHAM
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1700 HILLSIDE AVENUE
Mailing Address - Street 2:
Mailing Address - City:NEW HYDE PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11040-2606
Mailing Address - Country:US
Mailing Address - Phone:516-353-0211
Mailing Address - Fax:
Practice Address - Street 1:1700 HILLSIDE AVE
Practice Address - Street 2:
Practice Address - City:NEW HYDE PARK
Practice Address - State:NY
Practice Address - Zip Code:11040-2606
Practice Address - Country:US
Practice Address - Phone:516-353-0211
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-04-12
Last Update Date:2016-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst