Basic Information
| Provider Information | |||||||||
| NPI: | 1922015635 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | FORSTER-GLAZIER | ||||||||
| FirstName: | ELLEN | ||||||||
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| Credential: | NP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 41 E POST RD | ||||||||
| Address2: | |||||||||
| City: | WHITE PLAINS | ||||||||
| State: | NY | ||||||||
| PostalCode: | 106014607 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9146812560 | ||||||||
| FaxNumber: | 9146812590 | ||||||||
| Practice Location | |||||||||
| Address1: | 41 E POST RD | ||||||||
| Address2: | |||||||||
| City: | WHITE PLAINS | ||||||||
| State: | NY | ||||||||
| PostalCode: | 106014607 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9146812560 | ||||||||
| FaxNumber: | 9146812590 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/02/2006 | ||||||||
| LastUpdateDate: | 04/29/2013 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363L00000X | 333591 | NY | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner |
ID Information
| ID | Type | State | Issuer | Description | P3667861 | 01 | NY | OXFORD HEALTH PLANS | OTHER | 4C8269 | 01 | NY | HEALTH NET | OTHER |