Individual
KENNETH GLASER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1100 GRAMPIAN BLVD, WILLIAMSPORT, PA 17701-1909
(570) 326-8470
(570) 326-8590
Mailing address
1201 GRAMPIAN BLVD, WILLIAMSPORT, PA 17701-1900
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
MD045324E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001229855
—
PA
Enumeration date
09/20/2005
Last updated
07/20/2015
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