Organization
GLENFORD NIXON, M.D., P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GLENFORD NIXON (PRESIDENT)
(516) 922-1056
Entity
Organization
Contact information
Practice address
49 OAKCREST AVE, MIDDLE ISLAND, NY 11953-1415
(631) 924-8820
Mailing address
8 SOUTH RD, OYSTER BAY, NY 11771-1906
(516) 922-1056
(516) 624-2689
Taxonomy
Speciality
Code
Description
License number
State
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
173410-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
173410-1
NYS LICENSE
NY
Enumeration date
01/19/2013
Last updated
01/19/2013
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