Healthcare Provider Details

I. General information

NPI: 1386970424
Provider Name (Legal Business Name): JOY H. GLASER M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/25/2009
Last Update Date: 10/25/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 WINDCREST RD
RYE NY
10580-1625
US

IV. Provider business mailing address

1 WINDCREST RD
RYE NY
10580-1625
US

V. Phone/Fax

Practice location:
  • Phone: 914-925-0360
  • Fax: 914-925-0361
Mailing address:
  • Phone: 914-925-0360
  • Fax: 914-925-0361

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0208X
TaxonomyPediatric Infectious Diseases Physician
License Number096926
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code282NC2000X
TaxonomyChildren's Hospital
License Number096926
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: