Organization
GLASS BEACH MEDICAL SERVICES A MEDICAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KATHLEEN MARIE KONDAS (OFFICER)
(973) 251-1132
Entity
Organization
Contact information
Practice address
1A BURTON HILLS BLVD, NASHVILLE, TN 37215-6187
(973) 251-1132
Mailing address
5565 CENTERVIEW DR STE 107, RALEIGH, NC 27606-3563
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
—
—
Other
Enumeration date
12/10/2020
Last updated
12/14/2020
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