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Contact Information

SHANA M GLYNN, MS, RPA-C, RD, CDN
2550 VICTORY BOULEVARD
N/A
STATEN ISLAND, NY10314
 Phone: 718-983-1496
 Fax: 718-982-6309
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Physician Assistant

363A00000X 97 Physician Assistant
 

Dietitian, Registered

133V00000X 71 Registered Dietitian or Nutrition Professional
Indicates primary specialty

NPI Profile & details for SHANA M GLYNN · (Female)

NPI Number 1174996334
Status Active
Credentials MS, RPA-C, RD, CDN
Entity Individual
Enumeration date 11/09/2015
Last updated 05/15/2023 - About 3 years ago
Sole proprietor 1 No
Identifiers
  • NY License # 007626
  • NY License # 019490
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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