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Individual

MR. KENNETH J GLASGOW

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
OPTICIAN AAS

Contact information

Practice address
41 NORTH STREET, BUFFALO, NY 14202-1105
(716) 883-2020
(716) 883-2020
Mailing address
41 NORTH STREET, BUFFALO, NY 14202-1105
(716) 883-2020
(716) 883-2020

Taxonomy

Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
C003597
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00594803
NY
Enumeration date
11/27/2007
Last updated
11/27/2007
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