Individual
MR. JOHN L GLENN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
84 E. STATE ST, ST. MARY'S HOSPITAL, GLOVERSVILLE FAM HLTH CNTR, GLOVERSVILLE, NY 12078
(518) 773-8894
(518) 773-8125
Mailing address
427 GUY PARK AVE - PRIMARY & SPECIALTY CARE DEPT., ST. MARY'S HOSPITAL AT AMSTERDAM, AMSTERDAM, NY 12010
(518) 841-7430
(518) 841-7121
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
1575271
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00890859
—
NY
Enumeration date
05/03/2006
Last updated
09/02/2010
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