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NPI Code Detail

MEDICARE: MR. GLENN C WALSKI R.PH.

MEDICARE: MR. GLENN C WALSKI R.PH.
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
1183500000XPharmacist32808NY

General Provider Information

NPI Number : 1891934824
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. GLENN C WALSKI R.PH.
Provider Business Mailing Address
First Line : 245 E MAIN ST
Second Line :
City : MIDDLETOWN
State : NY
Zip : 10940-4017
Country : US
Telephone Number : 845-344-1056
Fax Number :
Provider Business Practice Location Address
First Line : 245 E MAIN ST
Second Line :
City : MIDDLETOWN
State : NY
Zip : 10940-4017
Country : US
Telephone Number : 845-344-1056
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/14/2009
Last Update Date : 02/14/2009

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