Provider Demographics
NPI:1114914611
Name:BELKIN, GLENN J (DO)
Entity Type:Individual
Prefix:
First Name:GLENN
Middle Name:J
Last Name:BELKIN
Suffix:
Gender:M
Credentials:DO
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Mailing Address - Street 1:22 SAW MILL RIVER RD
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:HAWTHORNE
Mailing Address - State:NY
Mailing Address - Zip Code:10532-1533
Mailing Address - Country:US
Mailing Address - Phone:914-304-5250
Mailing Address - Fax:914-345-1752
Practice Address - Street 1:503 GRASSLANDS RD
Practice Address - Street 2:STE 200
Practice Address - City:VALHALLA
Practice Address - State:NY
Practice Address - Zip Code:10595-1503
Practice Address - Country:US
Practice Address - Phone:914-304-5250
Practice Address - Fax:914-345-1752
Is Sole Proprietor?:No
Enumeration Date:2005-09-30
Last Update Date:2013-07-22
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Provider Licenses
StateLicense IDTaxonomies
NY1357212080P0006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0006XAllopathic & Osteopathic PhysiciansPediatricsDevelopmental - Behavioral Pediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00707759Medicaid
NYA400038750Medicare PIN