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NPI Code Detail

MEDICARE: MS. SANDRA HINES GLANTZ FNP

MEDICARE: MS. SANDRA HINES GLANTZ FNP
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
1363LF0000XFamily Nurse PractitionerF330495NY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1PO19419394OTHERNYBLUE CHOICE
27108OTHERTOTAL CARE
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4000924648001OTHERCOMMUNITY BLUE HEALTH NOW
5109390CKOTHERNYPREFERRED CARE

General Provider Information

NPI Number : 1881663052
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. SANDRA HINES GLANTZ FNP
Provider Business Mailing Address
First Line : 3690 EAST AVENUE
Second Line :
City : ROCHESTER
State : NY
Zip : 14618
Country : US
Telephone Number : 585-385-8280
Fax Number : 585-385-8299
Provider Business Practice Location Address
First Line : 3690 EAST AVE
Second Line :
City : ROCHESTER
State : NY
Zip : 14618-3537
Country : US
Telephone Number : 585-385-8280
Fax Number : 585-385-8299
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/17/2006
Last Update Date : 09/28/2015

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