Individual
MR. KIERAN GLACKEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
38 EDGEWOOD CIR, ORANGEBURG, NY 10962-1616
(845) 642-1505
Mailing address
38 EDGEWOOD CIR, ORANGEBURG, NY 10962-1616
(845) 642-1505
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
004559-1
NY
Other
Enumeration date
05/14/2007
Last updated
07/08/2007
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