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General NPI Number Information
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NPI Number | 1508104969
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Entity Type | Organization
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Legal Business Name | GLENFORD NIXON, M.D., P.C.
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Dates
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Enumeration Date | 01/19/2013
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Last Update Date | 01/19/2013
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Provider Practice Location Address
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Address Line | 49 OAKCREST AVE
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City | MIDDLE ISLAND
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State | NY
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Zip | 11953-1415
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Country | US
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Telephone | 631-924-8820
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Fax |
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Provider Business Mailing Address
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Address Line | 8 SOUTH RD
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City | OYSTER BAY
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State | NY
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Zip | 11771-1906
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Country | US
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Telephone | 516-922-1056
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Fax | 516-624-2689
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. GLENFORD NIXON
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Credential |
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Telephone | 516-922-1056
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0300X
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Taxonomy Name | Geriatric Medicine (Internal Medicine) Physician
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License Number | 173410-1
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License Number State | NY
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