| Doctor Name: | JONI-GAYLE GLASS |
| NPI Number: | 1740681576 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | RN |
| License Number: | 485182 |
| Business Practice Address: | 21 Mitchell Drive Sound Beach, NY - 117892437 |
| Business Phone Number: | 6317443524 |
| Business Fax Number: | 6317443524 |
| Mailing Address: | 21mitchell Drive, SOUND BEACH |
| State: | NY |
| Postal Code: | 117892437 |
| Phone Number: | 6317443524 |
| Fax Number: | 6317443524 |
| NPI Enumeration Date: | 09/11/2014 |
| NPI Last Update Date: | 09/11/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 163WH0200X |
| License Number: | 485182 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Nursing Service Providers |
| Taxonomy Classification: | Registered Nurse |
| Taxonomy Specialization: | Home Health |
| Taxonomy Definition: | |