Provider Demographics
NPI:1306284930
Name:RESTORATIVE MEDICINE, P.C.
Entity type:Organization
Organization Name:RESTORATIVE MEDICINE, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JUDITH
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:GLASER
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:516-327-9777
Mailing Address - Street 1:192 BON AIR AVE
Mailing Address - Street 2:
Mailing Address - City:NEW ROCHELLE
Mailing Address - State:NY
Mailing Address - Zip Code:10804-3105
Mailing Address - Country:US
Mailing Address - Phone:914-752-7797
Mailing Address - Fax:844-854-7503
Practice Address - Street 1:77 PONDFIELD RD # GFL2
Practice Address - Street 2:
Practice Address - City:BRONXVILLE
Practice Address - State:NY
Practice Address - Zip Code:10708-3809
Practice Address - Country:US
Practice Address - Phone:914-752-7797
Practice Address - Fax:844-854-7503
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-05
Last Update Date:2022-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY248529208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty