| Doctor Name: | GLAUCO MICHAEL MARESCA |
| NPI Number: | 1053370742 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MD |
| License Number: | 177246-1 |
| Business Practice Address: | 153 Homer Ave Cortland Memorial Hospital Cortland, NY - 130451243 |
| Business Phone Number: | 3157822620 |
| Business Fax Number: | 3157884980 |
| Mailing Address: | 1116 Arsenal St, Suite 504 WATERTOWN |
| State: | NY |
| Postal Code: | 136012229 |
| Phone Number: | 3157822620 |
| Fax Number: | 3157884980 |
| NPI Enumeration Date: | 03/21/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2085R0203X |
| License Number: | 177246-1 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Radiology |
| Taxonomy Specialization: | Therapeutic Radiology |
| Taxonomy Definition: | |