Provider Demographics
NPI:1780084095
Name:BARNES, GLENNDALY (PHARMD)
Entity type:Individual
Prefix:MR
First Name:GLENNDALY
Middle Name:
Last Name:BARNES
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3305 AVE BARAMAYA STE 100
Mailing Address - Street 2:
Mailing Address - City:PONCE
Mailing Address - State:PR
Mailing Address - Zip Code:00728-2777
Mailing Address - Country:US
Mailing Address - Phone:787-709-4036
Mailing Address - Fax:787-709-4039
Practice Address - Street 1:3305 AVE BARAMAYA STE 100
Practice Address - Street 2:
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00728-2777
Practice Address - Country:US
Practice Address - Phone:787-709-4036
Practice Address - Fax:787-709-4039
Is Sole Proprietor?:No
Enumeration Date:2014-08-25
Last Update Date:2014-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR5347183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR5347OtherPHARMACIST REGISTRATION