Individual
DR. GLENN G. TAYLOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
500 CHASE PKWY, WATERBURY, CT 06708-3346
(203) 755-6677
(203) 755-7166
Mailing address
500 CHASE PKWY, WATERBURY, CT 06708-3346
(203) 755-6677
(203) 755-7166
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
19904
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
D400001645
MEDICARE PTAN
—
Enumeration date
07/06/2006
Last updated
10/28/2016
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