Provider Demographics
NPI:1790968576
Name:GLENN S.QUITTELL D.P.M.
Entity Type:Organization
Organization Name:GLENN S.QUITTELL D.P.M.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DR.
Authorized Official - Prefix:
Authorized Official - First Name:GLENN
Authorized Official - Middle Name:S
Authorized Official - Last Name:QUITTELL
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:914-636-7836
Mailing Address - Street 1:140 LOCKWOOD AVE
Mailing Address - Street 2:SUITE 322
Mailing Address - City:NEW ROCHELLE
Mailing Address - State:NY
Mailing Address - Zip Code:10801-4915
Mailing Address - Country:US
Mailing Address - Phone:914-636-7836
Mailing Address - Fax:914-636-7487
Practice Address - Street 1:140 LOCKWOOD AVE
Practice Address - Street 2:SUITE 322
Practice Address - City:NEW ROCHELLE
Practice Address - State:NY
Practice Address - Zip Code:10801-4915
Practice Address - Country:US
Practice Address - Phone:914-636-7836
Practice Address - Fax:914-636-7487
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-14
Last Update Date:2008-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY4778960001Medicare NSC
NY1790968576Medicare NSC