Individual
GLENN DONOVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2601 OCEAN PKWY, BROOKLYN, NY 11235-7745
(718) 616-4408
(718) 616-4105
Mailing address
2228 63RD ST, BROOKLYN, NY 11204-3116
(718) 331-7480
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
N003550
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00811101
—
NY
Enumeration date
11/20/2006
Last updated
07/08/2007
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