MEDICARE: SHERRIE GLASSER PHYSICAL THERAPY JOHN DOUGLAS PHYSICAL THERAPIST ASST

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
1	174400000X	Specialist

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	27301	OTHER	NY	CIGNA
2	40839P	OTHER	NY	HIP/HEALTHCARE PARTNERS
3	QL0411	OTHER	NY	BLUE CROSS BLUE SHIELD
4	3422589	OTHER	NY	US HEALTHCARE
5	ANC1349	OTHER	NY	OXFORD
6	0141163	OTHER	NY	AETNA
7	76643	OTHER	NY	VYTRA
8	AZ00688	OTHER	NY	MDNY

General Provider Information

NPI Number	:	1467457820
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SHERRIE GLASSER PHYSICAL THERAPY JOHN DOUGLAS PHYSICAL THERAPIST ASST

Provider Business Mailing Address
First Line	:	256 N WELLWOOD AVE
Second Line	:
City	:	LINDENHURST
State	:	NY
Zip	:	11757-3707
Country	:	US
Telephone Number	:	631-957-7300
Fax Number	:	631-957-7024

Provider Business Practice Location Address
First Line	:	256 N WELLWOOD AVE
Second Line	:
City	:	LINDENHURST
State	:	NY
Zip	:	11757-3707
Country	:	US
Telephone Number	:	631-957-7300
Fax Number	:	631-957-7024

Authorized Official
Title or Position	:	PHYSICAL THERAPIST DIRECTOR
Name	:	SHERRIE GLASSER
Credential	:
Telephone Number	:	516-745-8050

Provider Enumeration Date	:	06/14/2005
Last Update Date	:	08/22/2020

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