Provider Demographics
NPI:1366470213
Name:GOLDFINGER, GLENN HARRIS (PT)
Entity type:Individual
Prefix:MR
First Name:GLENN
Middle Name:HARRIS
Last Name:GOLDFINGER
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:133 E 80TH ST STE 1
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10075-0317
Mailing Address - Country:US
Mailing Address - Phone:212-628-3192
Mailing Address - Fax:212-628-3215
Practice Address - Street 1:133 E 80TH ST STE 1
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10075-0317
Practice Address - Country:US
Practice Address - Phone:212-249-5485
Practice Address - Fax:212-249-5486
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-29
Last Update Date:2025-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY002535-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY2C6783OtherPHS
NY133248231OtherPHCS-GUARDIAN