Provider Demographics
NPI:1316971732
Name:GLANTZ, JOHN CHRISTOPHER (MD)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:CHRISTOPHER
Last Name:GLANTZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:601 ELMWOOD AVE
Mailing Address - Street 2:BOX 668
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14642-0001
Mailing Address - Country:US
Mailing Address - Phone:585-275-0638
Mailing Address - Fax:585-273-3359
Practice Address - Street 1:601 ELMWOOD AVE
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14642-0001
Practice Address - Country:US
Practice Address - Phone:585-275-4200
Practice Address - Fax:585-275-1416
Is Sole Proprietor?:No
Enumeration Date:2006-07-10
Last Update Date:2023-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY181184207V00000X, 207VM0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VM0101XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyMaternal & Fetal Medicine
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYMD286LOtherPREFERRED CARE
NYP010181184OtherBLUE CHOICE
NY01210219Medicaid
NY7603213OtherAETNA
NY1854OtherBLUE SHIELD OF ROCHESTER
NYJ400042505Medicare PIN
NY37149GMedicare PIN
NY7603213OtherAETNA