Healthcare Provider Details

I. General information

NPI: 1588663652
Provider Name (Legal Business Name): MORRIS I GLASSMAN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/20/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1940 COMMERCE ST
YORKTOWN HEIGHTS NY
10598-4428
US

IV. Provider business mailing address

1940 COMMERCE ST
YORKTOWN HEIGHTS NY
10598-4428
US

V. Phone/Fax

Practice location:
  • Phone: 914-962-5506
  • Fax: 914-962-0877
Mailing address:
  • Phone: 914-962-5506
  • Fax: 914-962-0877

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number108613
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: