Provider Demographics
NPI:1740866086
Name:GLODE, MARIA LOUISE (FNP)
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:LOUISE
Last Name:GLODE
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:636 DELAWARE AVE
Mailing Address - Street 2:
Mailing Address - City:DELMAR
Mailing Address - State:NY
Mailing Address - Zip Code:12054-2429
Mailing Address - Country:US
Mailing Address - Phone:518-308-8111
Mailing Address - Fax:
Practice Address - Street 1:636 DELAWARE AVE
Practice Address - Street 2:
Practice Address - City:DELMAR
Practice Address - State:NY
Practice Address - Zip Code:12054-2429
Practice Address - Country:US
Practice Address - Phone:518-308-8111
Practice Address - Fax:518-233-0903
Is Sole Proprietor?:No
Enumeration Date:2021-03-18
Last Update Date:2025-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY716760163W00000X
NY347802363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse