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General NPI Number Information
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NPI Number | 1952508251
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Entity Type | Organization
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Legal Business Name | GLENN D. ARVAN MD, PC
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Dates
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Enumeration Date | 06/29/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 661 DEER PARK AVE
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City | BABYLON
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State | NY
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Zip | 11702-1314
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Country | US
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Telephone | 631-661-0202
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Fax | 631-661-0559
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Provider Business Mailing Address
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Address Line | 661 DEER PARK AVE
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City | BABYLON
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State | NY
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Zip | 11702-1314
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Country | US
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Telephone | 631-661-0202
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Fax | 631-661-0559
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. GLENN DOUGLAS ARVAN
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Credential | M.D.
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Telephone | 631-661-0202
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | 120185
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License Number State | NY
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