Provider Demographics
NPI:1003461906
Name:GLOWACKI, MAURA J
Entity Type:Individual
Prefix:MRS
First Name:MAURA
Middle Name:J
Last Name:GLOWACKI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:121 ROYCROFT DR
Mailing Address - Street 2:
Mailing Address - City:WEST SENECA
Mailing Address - State:NY
Mailing Address - Zip Code:14224-4410
Mailing Address - Country:US
Mailing Address - Phone:716-675-8264
Mailing Address - Fax:
Practice Address - Street 1:121 ROYCROFT DR
Practice Address - Street 2:
Practice Address - City:WEST SENECA
Practice Address - State:NY
Practice Address - Zip Code:14224-4410
Practice Address - Country:US
Practice Address - Phone:716-675-8264
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-07
Last Update Date:2019-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider