Individual provider · Type 1 NPI

Glenn H. Fredenburg

Family Nurse Practitioner · Buffalo, NY

NPI number 1679152664 Active

Practice location

40 La Riviere Dr Ste 201
Buffalo, NY 14202-4344

Mailing address

9467 State Route 9
Chazy, NY 12921-2043

Specialties and licenses

TaxonomyCodeLicense
Family Nurse Practitioner Primary 363LF0000X101.0134798 (VT)

Family Nurse Practitioner: Definition to come...

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About NPI 1679152664

Glenn H. Fredenburg's National Provider Identifier is 1679152664, issued on Apr 6, 2021. The primary taxonomy on file is Family Nurse Practitioner (363LF0000X), and the practice location is in Buffalo, NY. The record was last updated on Apr 27, 2022.