Healthcare Provider Details

I. General information

NPI: 1649187329
Provider Name (Legal Business Name): BRIAN GLANTZ DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/26/2026
Last Update Date: 08/26/2026
Certification Date: 08/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

196 SWANSEA DR
SYRACUSE NY
13206-1900
US

IV. Provider business mailing address

703 GRANITE ST STE 3
BRAINTREE MA
02184-5350
US

V. Phone/Fax

Practice location:
  • Phone: 315-800-0761
  • Fax: 315-800-0762
Mailing address:
  • Phone:
  • Fax: 781-961-3370

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number056385
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: