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1679152664
GLENN H FREDENBURG
BUFFALO, NY
NPI
1679152664
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
363LF0000X Nurse Practitioner, Family
(Licence: VT 101.0134798)
Enumeration Date
2021-04-06
Last Update Date
2022-04-27
Business Address
GLENN H FREDENBURG
40 LA RIVIERE DR STE 201
BUFFALO, NY 14202-4344
Phone number: 518-335-5097
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Mailing Address
GLENN H FREDENBURG
9467 STATE ROUTE 9
CHAZY, NY 12921-2043
Phone number: 518-335-5097
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