Provider Demographics
NPI:1598163289
Name:GLIBOFF, LAURIE ANN
Entity Type:Individual
Prefix:MRS
First Name:LAURIE
Middle Name:ANN
Last Name:GLIBOFF
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:LAURIE
Other - Middle Name:ANN
Other - Last Name:MARKLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN, LPN
Mailing Address - Street 1:700 CORPORATE BOULEVARD
Mailing Address - Street 2:
Mailing Address - City:NEWBURGH
Mailing Address - State:NY
Mailing Address - Zip Code:12550
Mailing Address - Country:US
Mailing Address - Phone:845-561-3655
Mailing Address - Fax:845-561-0252
Practice Address - Street 1:700 CORPORATE BOULEVARD
Practice Address - Street 2:
Practice Address - City:NEWBURGH
Practice Address - State:NY
Practice Address - Zip Code:12550
Practice Address - Country:US
Practice Address - Phone:845-561-3655
Practice Address - Fax:845-561-0252
Is Sole Proprietor?:No
Enumeration Date:2014-12-11
Last Update Date:2015-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY380754163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health