Individual
MRS. DIRAINE GLANVILLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
6323 7TH AVE, 8TH FLOOR, BROOKLYN, NY 11220-4743
(929) 441-4335
(718) 975-3058
Mailing address
6323 7TH AVE, BROOKLYN, NY 11220-4743
(929) 441-4335
(718) 975-3058
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
011347
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00246075
—
NY
Enumeration date
09/25/2006
Last updated
01/19/2017
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