Individual
VYACHESLAV GLUKH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
31 GWENN LOOP, STATEN ISLAND, NY 10314-6401
(347) 733-1774
Mailing address
8023 19TH AVE APT 6J, BROOKLYN, NY 11214-1740
Taxonomy
Speciality
Code
Description
License number
State
193400000X
Single Specialty Group
Primary
019190
NY
Other
Enumeration date
11/04/2013
Last updated
02/01/2016
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