Provider Demographics
NPI:1124245063
Name:GLOTZBACH, KRISTI LEWIS (MD)
Entity type:Individual
Prefix:DR
First Name:KRISTI
Middle Name:LEWIS
Last Name:GLOTZBACH
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:3415 BAINBRIDGE AVE
Mailing Address - Street 2:ROSENTHAL 1
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10467-2403
Mailing Address - Country:US
Mailing Address - Phone:718-741-2596
Mailing Address - Fax:
Practice Address - Street 1:3415 BAINBRIDGE AVE
Practice Address - Street 2:ROSENTHAL 1
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10467-2403
Practice Address - Country:US
Practice Address - Phone:718-741-2596
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-20
Last Update Date:2024-12-12
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NYNY269942,2080P0202X
UT9792129-12052080P0203X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0203XAllopathic & Osteopathic PhysiciansPediatricsPediatric Critical Care Medicine
No2080P0202XAllopathic & Osteopathic PhysiciansPediatricsPediatric Cardiology