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NPI Code Detail

MEDICARE: MR. GLENN H FORSYTHE MSW, LCSW-R

MEDICARE:  MR. GLENN H FORSYTHE  MSW, LCSW-R
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
11041C0700XClinical Social Worker083054NY

General Provider Information

NPI Number : 1447559497
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. GLENN H FORSYTHE MSW, LCSW-R
Provider Business Mailing Address
First Line : 719 HARRISON ST
Second Line :
City : SYRACUSE
State : NY
Zip : 13210-2305
Country : US
Telephone Number : 315-464-3265
Fax Number : 315-464-3282
Provider Business Practice Location Address
First Line : 719 HARRISON STREET
Second Line :
City : SYRACUSE
State : NY
Zip : 13210-2305
Country : US
Telephone Number : 315-464-3265
Fax Number : 315-464-3282
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/16/2011
Last Update Date : 08/06/2023

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Directions to “ MR. GLENN H FORSYTHE MSW, LCSW-R” Practice Location

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