Anderson, Glen E
Anderson, Glen E is an individual health care provider with primary practice located at 1299 Route 9 , Gansevoort NY 12831-1560. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as his primary health care specialty. Anderson, Glen E can be contacted via phone (518) 761-6961.Contact Information
Primary practice address
1299 Route 9
Gansevoort NY 12831-1560
Phone: (518) 761-6961
Fax: (518) 761-1006
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant | 363A00000X | 005207 | New York |
Profile Details
| NPI number | 1801061288 |
|---|---|
| LBN Legal business name | Anderson, Glen E |
| Credentials | Physician's Assistant Certified (PA-C) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Apr 25th, 2008 |
| Last updated | Nov 16th, 2022 - about 2 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1801061288 | NPPES |
| New York | MEDICAID | 02346541 |
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