Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Glow Wellness Care Medical PLLC

Organization Nephrology Physician · NPI 1245072909

Glow Wellness Care Medical PLLC is a Nephrology Physician in East Northport, New York. Registered with an NPI since 2024.

In the registry since
2024
What do these letters mean?
PLLC — Professional limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

3027 Jericho Tpke
East Northport, NY 11731-6230
Phone: (516) 665-1476
Fax: (516) 620-3773
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Nephrology Physician (primary) Taxonomy 207RN0300X

Record details

NPI number1245072909
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Shahab Khan — Md · (347) 476-7399
NPI enumeratedJune 12, 2024
Last updated in NPPESJune 12, 2024
Certification dateJune 12, 2024
Mailing address3027 Jericho Tpke, East Northport, NY 11731-6230

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