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Contact Information

GLENN BRANTLEY
777 SEAVIEW AVE
SBPC:HEALTH HOME PROGRAM
STATEN ISLAND, NY10305
 Phone: 718-668-8061
 Fax: 718-668-8070
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Case Management

251B00000X
Indicates primary specialty

NPI Profile & details for GLENN BRANTLEY · (Male)

NPI Number 1255794137
Status Active
Credentials
Entity Individual
Enumeration date 03/30/2016
Last updated 03/30/2016 - About 10 years ago
Sole proprietor 1 Yes
Identifiers
  • NY Medicaid 00769306
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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