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NPI Code Detail

MEDICARE: FREDERICK GLASER

MEDICARE: FREDERICK GLASER
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
1225200000XPhysical Therapy Assistant005476NY

General Provider Information

NPI Number : 1376932715
Entity Type Code : Individual
Provider Name (Legal Business Name) : FREDERICK GLASER
Provider Business Mailing Address
First Line : 1154 SAW MILL RIVER RD
Second Line :
City : YONKERS
State : NY
Zip : 10710-3210
Country : US
Telephone Number : 914-968-4854
Fax Number :
Provider Business Practice Location Address
First Line : 1154 SAW MILL RIVER RD
Second Line :
City : YONKERS
State : NY
Zip : 10710-3210
Country : US
Telephone Number : 914-968-4854
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/22/2015
Last Update Date : 01/22/2015

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