Individual ProviderPhillip GlennRegistered NurseNursing Service ProvidersPractice Address1122 E 216th St, Bronx, NY 10469-2302(718) 874-9058PECOS EnrollmentBased on the most recent information from CMS, provider Phillip Glenn does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 7 days ago.Profile DetailsProvider ID1245668276Provider TypeIndividualFull NameGlenn, PhillipGenderMaleSole ProprietorNoEnumeration Date10/30/2013Last Updated10/30/2013Contact InformationPractice LocationPractice Address1122 E 216th St, Bronx, NY 10469-2302Phone(718) 874-9058FaxUnlisted FaxMailing LocationMailing Address1122 E 216th St, Bronx, NY 10469-2302PhoneUnlisted PhoneFaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode163W00000XPrimaryDescriptionRegistered NurseNursing Service ProvidersLicense677492New York