Provider Demographics
NPI:1730908674
Name:GLYNN, JOHN FRANCIS JR (RN)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:FRANCIS
Last Name:GLYNN
Suffix:JR
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:11 SQUARE HILL RD LOT 14
Mailing Address - Street 2:
Mailing Address - City:NEW WINDSOR
Mailing Address - State:NY
Mailing Address - Zip Code:12553-8423
Mailing Address - Country:US
Mailing Address - Phone:845-220-6006
Mailing Address - Fax:845-567-9523
Practice Address - Street 1:11 SQUARE HILL RD LOT 14
Practice Address - Street 2:
Practice Address - City:NEW WINDSOR
Practice Address - State:NY
Practice Address - Zip Code:12553-8423
Practice Address - Country:US
Practice Address - Phone:845-220-6006
Practice Address - Fax:845-567-9523
Is Sole Proprietor?:No
Enumeration Date:2024-10-08
Last Update Date:2024-10-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY468092-1163WI0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WI0500XNursing Service ProvidersRegistered NurseInfusion Therapy