Individual
GLENN WURTZEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MS, NP-P, APRN-BC
Contact information
Practice address
140 RIVERSIDE DR, SUITE 1-O, NEW YORK, NY 10024-2605
(212) 988-4704
(212) 988-4706
Mailing address
140 RIVERSIDE DR, SUITE 1-O, NEW YORK, NY 10024-2605
(212) 988-4704
(212) 988-4706
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
517707
NY
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
400680
NY
Other
Enumeration date
10/17/2005
Last updated
04/03/2015
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