Organization
KEYSTONE MEDICAL SERVICES OF NEW YORK, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SANFORD GLANTZ MD (OWNER)
(901) 795-3600
Entity
Organization
Contact information
Practice address
224 E MAIN ST, SPRINGVILLE, NY 14141-1443
(716) 592-2871
Mailing address
PO BOX 281562, ATLANTA, GA 30384-1562
(904) 482-1070
(904) 482-1077
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
005123271
BLUE SHIELD OF NY
NY
05
—
02583535
—
NY
Enumeration date
07/04/2006
Last updated
01/06/2022
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