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General NPI Number Information
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NPI Number | 1063079309
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Entity Type | Individual
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Provider Name | VASSILI GLAZYRINE MD
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Gender | Male
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Dates
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Enumeration Date | 05/22/2019
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Last Update Date | 08/19/2024
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Provider Practice Location Address
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Address Line | 17 RIVERSIDE ST
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City | NASHUA
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State | NH
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Zip | 03062-1304
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Country | US
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Telephone | 603-577-3190
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Fax | 603-577-3191
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Provider Business Mailing Address
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Address Line | 4 ELLIOT WAY STE 200
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City | MANCHESTER
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State | NH
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Zip | 03103-3553
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Country | US
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Telephone | 603-836-1590
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Fax | 603-836-1616
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208800000X
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Taxonomy Name | Urology Physician
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License Number | 32139
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License Number State | NH
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