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Individual

MR. JOSHUA L. GLEINER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA-C

Contact information

Practice address
167 MAIN ST STE 2, GORHAM, NH 03581-1637
(802) 233-3729
Mailing address
167 MAIN ST STE 2, GORHAM, NH 03581-1637
(603) 752-2900

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
055-0030972
VT
363A00000X
Physician Assistant
Primary
1121
NH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000543003
MEDICARE PTAN
VT
05
3075818
NH
05
9000353
VT
Enumeration date
10/16/2007
Last updated
09/11/2024
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