Provider Demographics
NPI:1073622114
Name:GLASS, ANDREW RIGBY (DPM)
Entity Type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:RIGBY
Last Name:GLASS
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 HILLSIDE AVE
Mailing Address - Street 2:
Mailing Address - City:MANHASSET
Mailing Address - State:NY
Mailing Address - Zip Code:11030-2252
Mailing Address - Country:US
Mailing Address - Phone:516-314-6484
Mailing Address - Fax:212-867-3845
Practice Address - Street 1:315 MADISON AVE
Practice Address - Street 2:RM 2301
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10017-5413
Practice Address - Country:US
Practice Address - Phone:212-867-2500
Practice Address - Fax:212-867-2500
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-30
Last Update Date:2017-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYN006132213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist