Provider Demographics
NPI:1952599441
Name:CALLENDER, GLENDA GRACE (MD)
Entity Type:Individual
Prefix:
First Name:GLENDA
Middle Name:GRACE
Last Name:CALLENDER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 208062
Mailing Address - Street 2:330 CEDAR ST, FMB 130
Mailing Address - City:NEW HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06520-8062
Mailing Address - Country:US
Mailing Address - Phone:203-737-2036
Mailing Address - Fax:203-785-2498
Practice Address - Street 1:133 SCOVILL ST STE 303
Practice Address - Street 2:
Practice Address - City:WATERBURY
Practice Address - State:CT
Practice Address - Zip Code:06706-1127
Practice Address - Country:US
Practice Address - Phone:203-709-6871
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-10-09
Last Update Date:2019-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT516302086X0206X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086X0206XAllopathic & Osteopathic PhysiciansSurgerySurgical Oncology