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Individual

DR. GLENN HOWARD PISK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
2129 W OREGON AVE, FIRST FLOOR REAR, PHILADELPHIA, PA 19145-4131
(215) 462-6106
(215) 462-5922
Mailing address
2129 W OREGON AVE, FIRST FLOOR REAR, PHILADELPHIA, PA 19145-4131
(215) 462-6106
(215) 462-5922

Taxonomy

Speciality
Code
Description
License number
State
2080A0000X
Pediatric Adolescent Medicine Physician
Primary
MD0411084L
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0016075460001
PA
Enumeration date
05/22/2006
Last updated
07/11/2013
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