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NPI Code Detail

MEDICARE: LAURIE CARYN GLASSMAN M.D., F.A.A.P.

MEDICARE: LAURIE CARYN GLASSMAN M.D., F.A.A.P.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208000000XPediatrics Physician034744CT

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1205877081
Entity Type Code : Individual
Provider Name (Legal Business Name) : LAURIE CARYN GLASSMAN M.D., F.A.A.P.
Provider Business Mailing Address
First Line : 21 COACHMAN LN
Second Line :
City : BETHANY
State : CT
Zip : 06524-3256
Country : US
Telephone Number : 203-589-7758
Fax Number :
Provider Business Practice Location Address
First Line : 299 WASHINGTON AVE STE LL
Second Line :
City : HAMDEN
State : CT
Zip : 06518-3039
Country : US
Telephone Number : 203-288-4288
Fax Number : 855-414-4010
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/10/2006
Last Update Date : 04/30/2024

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