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NPI Code Detail

MEDICARE: DR. GLENN FLEISCHHACKER D.O.

MEDICARE: DR. GLENN FLEISCHHACKER D.O.
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
1207L00000XAnesthesiology Physician188267NY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1871599597
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. GLENN FLEISCHHACKER D.O.
Provider Business Mailing Address
First Line : 30 VILLAGE HILL DR
Second Line :
City : DIX HILLS
State : NY
Zip : 11746-5522
Country : US
Telephone Number : 631-513-9219
Fax Number :
Provider Business Practice Location Address
First Line : 888 OLD COUNTRY RD
Second Line :
City : PLAINVIEW
State : NY
Zip : 11803-4914
Country : US
Telephone Number : 516-719-3000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/27/2005
Last Update Date : 03/20/2023

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