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Individual

MRS. CRYSTAL GLENN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
RN

Contact information

Practice address
596 SAINT LAWRENCE AVE, BUFFALO, NY 14216-1513
(716) 253-7204
Mailing address
596 SAINT LAWRENCE AVE, BUFFALO, NY 14216-1513
(716) 253-7204

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
639409
NY

Other

Enumeration date
04/22/2021
Last updated
04/22/2021
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