| Doctor Name: | DR. GLEN ALAN COLODNY |
| NPI Number: | 1154690618 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | D.C., R.D. |
| License Number: | 960913 |
| Business Practice Address: | 226 Burns St Forest Hills, NY - 113756130 |
| Business Phone Number: | 9174352893 |
| Business Fax Number: | 7182683598 |
| Mailing Address: | 226 Burns St, FOREST HILLS |
| State: | NY |
| Postal Code: | 113756130 |
| Phone Number: | 9174352893 |
| Fax Number: | 7182683598 |
| NPI Enumeration Date: | 12/29/2011 |
| NPI Last Update Date: | 12/29/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 133V00000X |
| License Number: | 960913 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | NY |
| Taxonomy Type: | Dietary & Nutritional Service Providers |
| Taxonomy Classification: | Dietitian, Registered |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A registered dietician (RD) is a food and nutrition expert who has successfully completed a minimum of a bachelor |