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NPI Code Detail

MEDICARE: GLENN A MRGICH BA CASAC

MEDICARE: GLENN A MRGICH BA CASAC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YA0400XAddiction (Substance Use Disorder) Counselor

General Provider Information

NPI Number : 1396832762
Entity Type Code : Individual
Provider Name (Legal Business Name) : GLENN A MRGICH BA CASAC
Provider Business Mailing Address
First Line : 227 THORN AVE
Second Line : PO BOX 631
City : ORCHARD PARK
State : NY
Zip : 14127-2600
Country : US
Telephone Number : 716-662-2040
Fax Number : 716-662-0019
Provider Business Practice Location Address
First Line : 1280 MAIN ST
Second Line :
City : BUFFALO
State : NY
Zip : 14209-1912
Country : US
Telephone Number : 716-583-8503
Fax Number : 716-882-0293
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/06/2006
Last Update Date : 01/25/2026

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Directions to “ GLENN A MRGICH BA CASAC” Practice Location

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