Provider Demographics
NPI:1144291956
Name:BOYAR, GLENN HOWARD (MD)
Entity type:Individual
Prefix:
First Name:GLENN
Middle Name:HOWARD
Last Name:BOYAR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:110 S BEDFORD RD
Mailing Address - Street 2:CAREMOUNT MEDICAL PC
Mailing Address - City:MOUNT KISCO
Mailing Address - State:NY
Mailing Address - Zip Code:10549-3446
Mailing Address - Country:US
Mailing Address - Phone:914-241-1050
Mailing Address - Fax:914-242-1516
Practice Address - Street 1:672 STONELEIGH AVE
Practice Address - Street 2:
Practice Address - City:CARMEL
Practice Address - State:NY
Practice Address - Zip Code:10512-4634
Practice Address - Country:US
Practice Address - Phone:845-279-2000
Practice Address - Fax:845-279-7730
Is Sole Proprietor?:No
Enumeration Date:2006-01-30
Last Update Date:2016-11-15
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY208021207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02103799Medicaid
NY02103799Medicaid
NY859721Medicare PIN
NYA400009651Medicare PIN
NY3545863OtherAETNA HMO
NYP3236730OtherOXFORD
NY4126108OtherMVP
NY02103799Medicaid
NY000416488001OtherHEALTH NOW
NM83897OtherGHI HMO
NY0D3135OtherHEALTHNET
NY2413558OtherUNITED
NY7659602OtherAETNA PPO7659602
GB08597210OtherEMPIRE BLUE CROSS
2228854OtherFIRST HEALTH
NMH25616Medicare UPIN
NY2197879OtherGHI
NYP00000205683OtherGHI MEDICAE PPO
208021OtherCONNECTICARE