Individual
DR. GLENN DOUGLAS SCIBILIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
375 E MAIN ST, SUITE 24, BAY SHORE, NY 11706
(631) 665-1330
(631) 665-1363
Mailing address
375 E MAIN ST, SUITE 24, BAY SHORE, NY 11706
(631) 665-1330
(631) 665-1363
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
190316
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01592429
—
NY
Enumeration date
03/17/2006
Last updated
10/17/2012
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