Provider Demographics
NPI:1407984339
Name:GEORGE, GLENDIS (RN)
Entity Type:Individual
Prefix:MS
First Name:GLENDIS
Middle Name:
Last Name:GEORGE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:416 E 26TH ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11226-7708
Mailing Address - Country:US
Mailing Address - Phone:718-951-9009
Mailing Address - Fax:718-951-9719
Practice Address - Street 1:1463 FLATBUSH AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11210-2428
Practice Address - Country:US
Practice Address - Phone:718-951-9009
Practice Address - Fax:718-951-9719
Is Sole Proprietor?:No
Enumeration Date:2007-03-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)