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NPI Code Detail

MEDICARE: KATHLEEN J GLENN-ROBERTS RPA

MEDICARE:   KATHLEEN J GLENN-ROBERTS  RPA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363A00000XPhysician Assistant06946NY

General Provider Information

NPI Number : 1316150428
Entity Type Code : Individual
Provider Name (Legal Business Name) : KATHLEEN J GLENN-ROBERTS RPA
Provider Business Mailing Address
First Line : 23 HAMMOND LN
Second Line :
City : PLATTSBURGH
State : NY
Zip : 12901-2000
Country : US
Telephone Number : 518-561-1322
Fax Number : 518-561-3420
Provider Business Practice Location Address
First Line : 75 BEEKMAN ST
Second Line :
City : PLATTSBURGH
State : NY
Zip : 12901-1427
Country : US
Telephone Number : 518-562-7500
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/07/2007
Last Update Date : 04/25/2025

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Directions to “ KATHLEEN J GLENN-ROBERTS RPA” Practice Location

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