Individual
HEIDI GLOVACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
4900 BROAD RD, SYRACUSE, NY 13215-2265
(315) 492-5553
Mailing address
PO BOX 2000, EAST SYRACUSE, NY 13057-9926
(315) 362-5129
(315) 362-5179
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
585729
NY
163W00000X
Registered Nurse
585729-1
NY
367500000X
Certified Registered Nurse Anesthetist
Primary
585729
NY
Other
Enumeration date
11/25/2008
Last updated
03/15/2011
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