Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0202X | Pediatric Cardiologist | NY269942, | NY |
NPI | 1124245063 |
---|---|
Provider Name | Dr. Kristi Lewis Glotzbach |
First Address | Bronx, NY 10467-2403 |
Second Address | Bronx, NY 10467-2403 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/04/2007 |
Last Update Date | 01/11/2021 |