Provider Demographics
NPI:1447234042
Name:PFEFFER, GLENN C (PT)
Entity Type:Individual
Prefix:
First Name:GLENN
Middle Name:C
Last Name:PFEFFER
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2606 FOX CHASE CT
Mailing Address - Street 2:
Mailing Address - City:BRIDGEVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:15017-1610
Mailing Address - Country:US
Mailing Address - Phone:412-914-0158
Mailing Address - Fax:
Practice Address - Street 1:363 VANADIUM RD
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15243-1497
Practice Address - Country:US
Practice Address - Phone:412-429-0885
Practice Address - Fax:412-429-0409
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT009750225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist