Provider Demographics
NPI:1922015635
Name:FORSTER-GLAZIER, ELLEN (NP)
Entity Type:Individual
Prefix:
First Name:ELLEN
Middle Name:
Last Name:FORSTER-GLAZIER
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:41 E POST RD
Mailing Address - Street 2:
Mailing Address - City:WHITE PLAINS
Mailing Address - State:NY
Mailing Address - Zip Code:10601-4607
Mailing Address - Country:US
Mailing Address - Phone:914-681-2560
Mailing Address - Fax:914-681-2590
Practice Address - Street 1:41 E POST RD
Practice Address - Street 2:
Practice Address - City:WHITE PLAINS
Practice Address - State:NY
Practice Address - Zip Code:10601-4607
Practice Address - Country:US
Practice Address - Phone:914-681-2560
Practice Address - Fax:914-681-2590
Is Sole Proprietor?:No
Enumeration Date:2006-08-02
Last Update Date:2013-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY333591363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYP3667861OtherOXFORD HEALTH PLANS
NY4C8269OtherHEALTH NET
NY4C8269OtherHEALTH NET
NY2E7831Medicare ID - Type Unspecified