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General NPI Number Information
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NPI Number | 1700867413
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Entity Type | Individual
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Provider Name | GLENN D BABUS DO
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Gender | Male
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Dates
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Enumeration Date | 11/09/2005
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Last Update Date | 01/09/2019
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Provider Practice Location Address
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Address Line | 1099 TARGEE ST
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City | STATEN ISLAND
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State | NY
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Zip | 10304
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Country | US
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Telephone | 718-448-3210
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Fax | 718-984-2642
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Provider Business Mailing Address
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Address Line | 2535 ARTHUR KILL RD
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City | STATEN ISLAND
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State | NY
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Zip | 10309-1207
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Country | US
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Telephone | 718-448-3210
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Fax | 718-984-2642
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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 | 207LP2900X
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Taxonomy Name | Pain Medicine (Anesthesiology) Physician
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License Number | J0434
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 207LP2900X
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Taxonomy Name | Pain Medicine (Anesthesiology) Physician
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License Number | H0073176
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License Number State | MD
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Taxonomy #3
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Taxonomy Code | 207LP2900X
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Taxonomy Name | Pain Medicine (Anesthesiology) Physician
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License Number | 0102201908
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License Number State | VA
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Taxonomy #4
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Taxonomy Code | 207LP2900X
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Taxonomy Name | Pain Medicine (Anesthesiology) Physician
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License Number | DO0000002111
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License Number State | TN
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Taxonomy #5
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Taxonomy Code | 207LP2900X
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Taxonomy Name | Pain Medicine (Anesthesiology) Physician
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License Number | 25MB09495900
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License Number State | NJ
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Taxonomy #6
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Taxonomy Code | 207LP2900X
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Taxonomy Name | Pain Medicine (Anesthesiology) Physician
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License Number | 228217-1
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License Number State | NY
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