Provider Demographics
NPI:1316903792
Name:GLYPTIS, ANDREW (MD)
Entity type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:
Last Name:GLYPTIS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 167
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10471-0167
Mailing Address - Country:US
Mailing Address - Phone:212-333-3347
Mailing Address - Fax:212-262-5120
Practice Address - Street 1:330 W 58 ST.
Practice Address - Street 2:STE. 413
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10019-1820
Practice Address - Country:US
Practice Address - Phone:212-333-3347
Practice Address - Fax:212-262-5120
Is Sole Proprietor?:No
Enumeration Date:2006-04-25
Last Update Date:2014-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY199198207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01716343Medicaid
NY01716343Medicaid
NYG38929Medicare UPIN