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General NPI Number Information
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NPI Number | 1619991338
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Entity Type | Individual
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Provider Name | GARY GLAZER MD
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Gender | Male
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Dates
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Enumeration Date | 07/26/2006
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Last Update Date | 04/07/2015
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Provider Practice Location Address
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Address Line | 220 ALEXANDER ST SUITE 106
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City | ROCHESTER
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State | NY
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Zip | 14607-4008
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Country | US
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Telephone | 585-546-1272
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Fax | 585-325-4443
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Provider Business Mailing Address
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Address Line | 220 ALEXANDER ST SUITE 106
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City | ROCHESTER
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State | NY
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Zip | 14607-4008
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Country | US
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Telephone | 585-546-1272
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Fax | 585-325-4443
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 179413
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License Number State | NY
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