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SHANA MARIE GLYNN MS, RPA-C, RD, CDN
NPI 1174996334
Physician Assistant in Calverton, NY

Active since November 09, 2015
525 JAN WAY, CALVERTON, NY 11933(631) 508-5400(631) 910-2322 Get Directions Write a Review

NPPES record last updated: May 15, 2023. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: May 15, 2023, Mar 17, 2018, Aug 28, 2017 and 3 more (6 updates tracked since 2015).

About Shana Marie Glynn Ms, Rpa-c, Rd, Cdn NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SHANA MARIE GLYNN MS, RPA-C, RD, CDN (NPI 1174996334) is an individual physician assistant in Calverton, New York, licensed in New York (019490) and active in the NPI registry since November 2015.

NPPES Registry Identity

NPI1174996334
Entity TypeIndividualFemale
Primary Taxonomy363A00000X
Provider Legal NameSHANA MARIE GLYNNCredential: MS, RPA-C, RD, CDN
Location Address525 JAN WAYCalverton, NY 11933
Mailing Address525 Jan WayCalverton, NY 11933-3005 · (631) 508-5400 · Fax (631) 910-2322
Phone(631) 508-5400
Fax(631) 910-2322
Sole ProprietorNo
Enumeration DateNovember 9, 2015
Last NPPES UpdateMay 15, 20236 updates tracked since enumeration
NPPES CertifiedMay 15, 2023
✔ NPI 1174996334 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
License✔ Licensed in NY · 019490
Definition

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

Also ListedDietitian, RegisteredTaxonomy 133V00000X · License 007626 (NY)
525 JAN WAY, Calverton, NY 11933
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Other Providers at the Same Location


The following 4 providers are registered at the same or a nearby location.

EBDK AT CALVERTON
Substance Abuse Rehabilitation Facility
525 JAN WAY
CALVERTON, NY 11933
Suffolk County (631) 508-5400
DR. ROHAN JEET SINGH M.D.
Internal Medicine (Addiction Medicine)
525 JAN WAY
CALVERTON, NY 11933
Suffolk County (631) 508-5400
DR. EDMOND HAKIMI D.O
Internal Medicine (Addiction Medicine)
525 JAN WAY
CALVERTON, NY 11933
Suffolk County (631) 508-5400
MS. JANETTE M SPERANDEO NP
Nurse Practitioner (Adult Health)
525 JAN WAY
CALVERTON, NY 11933
Suffolk County (631) 508-5519

Frequently Asked Questions

What is Shana Glynn's NPI number?

The NPI number assigned to this healthcare provider is 1174996334, enumerated as an "individual" on November 09, 2015.

Where is the provider located?

The provider is located at 525 JAN WAY CALVERTON, NY 11933 and the phone number is (631) 508-5400.

What is the provider's specialty?

Physician Assistant with taxonomy code 363A00000X.