Provider Demographics
NPI:1679217269
Name:GLOWIENKA, JOSEPH DAVID
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:DAVID
Last Name:GLOWIENKA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:85 ROBINSON ST
Mailing Address - Street 2:
Mailing Address - City:BINGHAMTON
Mailing Address - State:NY
Mailing Address - Zip Code:13901-2521
Mailing Address - Country:US
Mailing Address - Phone:607-722-4221
Mailing Address - Fax:
Practice Address - Street 1:335 MAIN ST
Practice Address - Street 2:
Practice Address - City:JOHNSON CITY
Practice Address - State:NY
Practice Address - Zip Code:13790-2050
Practice Address - Country:US
Practice Address - Phone:607-777-9801
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-21
Last Update Date:2023-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY068963183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist