Healthcare Provider Details

I. General information

NPI: 1588930994
Provider Name (Legal Business Name): JOHN JAMES GLOGOWSKI NP-BC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/29/2012
Last Update Date: 11/02/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

262 NEW LUDLOW ROAD CHICOPEE MEDICAL CENTER
CHICOPEE MA
01020
US

IV. Provider business mailing address

260 NEW LUDLOW ROAD WESTERN MASS PHYSICIAN ASSOCIATES, INC
CHICOPEE MA
01020
US

V. Phone/Fax

Practice location:
  • Phone: 413-552-3250
  • Fax: 413-552-3255
Mailing address:
  • Phone: 413-534-2622
  • Fax: 413-534-2661

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberRN2277407
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: