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NPI Code Detail

MEDICARE: BARRY D GLAZ RPH

MEDICARE: BARRY D GLAZ RPH
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
1183500000XPharmacist033316NY

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 : 1912188756
Entity Type Code : Individual
Provider Name (Legal Business Name) : BARRY D GLAZ RPH
Provider Business Mailing Address
First Line : 11 WELLINGTON CT
Second Line :
City : STATEN ISLAND
State : NY
Zip : 10314-7839
Country : US
Telephone Number : 718-494-8350
Fax Number : 718-494-8350
Provider Business Practice Location Address
First Line : 2271 RICHMOND AVE
Second Line :
City : STATEN ISLAND
State : NY
Zip : 10314-3903
Country : US
Telephone Number : 718-698-0500
Fax Number : 718-370-0590
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/20/2007
Last Update Date : 11/20/2007

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