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General NPI Number Information
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NPI Number | 1225326424
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Entity Type | Organization
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Legal Business Name | NORTH HARBOR MEDICAL PLLC
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Dates
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Enumeration Date | 07/21/2011
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Last Update Date | 07/21/2011
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Provider Practice Location Address
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Address Line | 152 E MAIN ST SUITE C
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City | HUNTINGTON
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State | NY
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Zip | 11743-2958
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Country | US
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Telephone | 631-421-2185
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Fax |
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Provider Business Mailing Address
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Address Line | 152 E MAIN ST SUITE C
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City | HUNTINGTON
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State | NY
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Zip | 11743-2958
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Country | US
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Telephone | 631-421-2185
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Fax |
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Authorized Official
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Title or Position | MEMBER
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Name | DR. BARRY GLANZMAN
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Credential | MD
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Telephone | 631-421-2185
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number |
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License Number State |
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