Pisk, Glenn Howard

Pisk, Glenn Howard is an individual health care provider with primary practice located at 2129 W Oregon Ave First Floor Rear, Philadelphia PA 19145-4131. He recently has only one registered license in Allopathic & Osteopathic Physicians / Adolescent Medicine, which is considered as his primary health care specialty. Pisk, Glenn Howard can be contacted via phone (215) 462-6106.

Contact Information

Primary practice address
2129 W Oregon Ave First Floor Rear Philadelphia PA 19145-4131
Phone: (215) 462-6106
Fax: (215) 462-5922
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Adolescent Medicine 2080A0000X MD0411084L Pennsylvania

Profile Details

NPI number 1114971066
LBN Legal business name Pisk, Glenn Howard
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 22nd, 2006
Last updated Jul 11th, 2013 - about 12 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1114971066 NPPES
Pennsylvania MEDICAID 0016075460001

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