GLENN H FREDENBURG NPI 1679152664

NPI Information

NPI: 1679152664
Provider Name: GLENN H FREDENBURG
Classification: Nurse Practitioner - 363LF0000X
Entity Type: Individual

Specialization: Family

PECOS Registration: Yes

Address:
40 LA RIVIERE DR STE 201
BUFFALO, NY
ZIP 14202
Phone: (518) 335-5097
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Glenn H Fredenburg is a family nurse practitioner in Buffalo, NY. Glenn H Fredenburg NPI is 1679152664. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

40 LA RIVIERE DR STE 201
BUFFALO, NY
ZIP 14202-344
Phone: (518) 335-5097

The NPI 1679152664 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 4/6/2021 and was last updated on 4/27/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LF0000X	Nurse Practitioner	Family	101.0134798	VERMONT	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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