Provider Demographics
NPI:1750467031
Name:GLASHEN, MARLENE (ANP)
Entity Type:Individual
Prefix:
First Name:MARLENE
Middle Name:
Last Name:GLASHEN
Suffix:
Gender:F
Credentials:ANP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1069 HEMPSTEAD TPKE STE 4
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN SQUARE
Mailing Address - State:NY
Mailing Address - Zip Code:11010-2631
Mailing Address - Country:US
Mailing Address - Phone:155-024-0015
Mailing Address - Fax:631-792-7011
Practice Address - Street 1:1069 HEMPSTEAD TPKE STE 4
Practice Address - Street 2:
Practice Address - City:FRANKLIN SQUARE
Practice Address - State:NY
Practice Address - Zip Code:11010
Practice Address - Country:US
Practice Address - Phone:155-024-0015
Practice Address - Fax:631-792-7011
Is Sole Proprietor?:No
Enumeration Date:2006-10-28
Last Update Date:2018-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF300566363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health