Provider Demographics
NPI:1063617017
Name:MCGLYNN, MARSHA ANNA (MA)
Entity type:Individual
Prefix:MRS
First Name:MARSHA
Middle Name:ANNA
Last Name:MCGLYNN
Suffix:
Gender:F
Credentials:MA
Other - Prefix:MS
Other - First Name:MARSHA
Other - Middle Name:ANNA
Other - Last Name:PFEIL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA
Mailing Address - Street 1:242 EXT EAST STATE ST
Mailing Address - Street 2:
Mailing Address - City:GLOVERSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:12078-1445
Mailing Address - Country:US
Mailing Address - Phone:518-842-5165
Mailing Address - Fax:518-580-2240
Practice Address - Street 1:242 EXT EAST STATE ST
Practice Address - Street 2:
Practice Address - City:GLOVERSVILLE
Practice Address - State:NY
Practice Address - Zip Code:12078-1445
Practice Address - Country:US
Practice Address - Phone:518-842-5165
Practice Address - Fax:518-580-2240
Is Sole Proprietor?:No
Enumeration Date:2007-06-19
Last Update Date:2010-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000981-1231H00000X
NY14000019974237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
No237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter