Provider Demographics
NPI:1275884504
Name:GLOGOWSKI, TRACEY C (MS ED)
Entity Type:Individual
Prefix:MRS
First Name:TRACEY
Middle Name:C
Last Name:GLOGOWSKI
Suffix:
Gender:F
Credentials:MS ED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:63 BLUE SPRUCE LN
Mailing Address - Street 2:
Mailing Address - City:BALLSTON LAKE
Mailing Address - State:NY
Mailing Address - Zip Code:12019-1322
Mailing Address - Country:US
Mailing Address - Phone:518-899-1042
Mailing Address - Fax:
Practice Address - Street 1:63 BLUE SPRUCE LN
Practice Address - Street 2:
Practice Address - City:BALLSTON LAKE
Practice Address - State:NY
Practice Address - Zip Code:12019-1322
Practice Address - Country:US
Practice Address - Phone:518-899-1042
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-26
Last Update Date:2012-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist