Provider Demographics
NPI:1588341044
Name:GLEBOVA, VALENTINA
Entity type:Individual
Prefix:
First Name:VALENTINA
Middle Name:
Last Name:GLEBOVA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8827 ROUTE 23A
Mailing Address - Street 2:
Mailing Address - City:HUNTER
Mailing Address - State:NY
Mailing Address - Zip Code:12442-5329
Mailing Address - Country:US
Mailing Address - Phone:518-263-4387
Mailing Address - Fax:
Practice Address - Street 1:8827 ROUTE 23A
Practice Address - Street 2:
Practice Address - City:HUNTER
Practice Address - State:NY
Practice Address - Zip Code:12442-5329
Practice Address - Country:US
Practice Address - Phone:518-263-4387
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-28
Last Update Date:2023-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY352353207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine