Brantley, Glenn
Brantley, Glenn is an sole proprietor health care provider with primary practice located at 777 Seaview Ave Sbpc:Health Home Program, Staten Island NY 10305. He recently has only one registered license in Agencies / Case Management, which is considered as his primary health care specialty. Brantley, Glenn can be contacted via phone (718) 668-8061.Contact Information
Primary practice address
777 Seaview Ave Sbpc:Health Home Program
Staten Island NY 10305
Phone: (718) 668-8061
Fax: (718) 668-8070
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Agencies / Case Management | 251B00000X |
Profile Details
| NPI number | 1255794137 |
|---|---|
| LBN Legal business name | Brantley, Glenn |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Mar 30th, 2016 |
| Last updated | Mar 30th, 2016 - about 8 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 | 1255794137 | NPPES |
| New York | MEDICAID | 00769306 |
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