Individual
DR. ROBERT GLEN LARSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
7411 263RD ST APT A1, GLEN OAKS, NY 11004-1161
(503) 330-6123
Mailing address
7411 263RD ST APT A1, GLEN OAKS, NY 11004-1161
(503) 330-6123
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
60-258701
NY
Other
Enumeration date
10/20/2010
Last updated
10/20/2010
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