Healthcare Provider Details

I. General information

NPI: 1588127088
Provider Name (Legal Business Name): JOANNA MICHELLE GLANZ MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/11/2019
Last Update Date: 10/27/2026
Certification Date: 10/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

851 MIDDLE ST STE 1100
FALL RIVER MA
02721-1779
US

IV. Provider business mailing address

851 MIDDLE ST STE 1100
FALL RIVER MA
02721-1779
US

V. Phone/Fax

Practice location:
  • Phone: 508-324-6800
  • Fax: 508-342-6808
Mailing address:
  • Phone: 508-324-6800
  • Fax: 508-324-6808

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number1014620
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: