Individual
GLENN G BOETTGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
2446 WASHINGTON AVE, OCEANSIDE, NY 11572
(516) 536-0946
(516) 536-4495
Mailing address
3998 FAIR RIDGE DR, SUITE 300, FAIRFAX, VA 22033
(703) 295-9360
(703) 766-9725
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
4334941
NY
Other
Enumeration date
08/17/2006
Last updated
03/25/2015
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