Healthcare Provider Details

I. General information

NPI: 1356349930
Provider Name (Legal Business Name): GEORGE N GLOSIK ROBERT J GLOSIK
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/08/2005
Last Update Date: 06/01/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7305 BROADVIEW RD.
SEVEN HILLS OH
44131-4442
US

IV. Provider business mailing address

7305 BROADVIEW RD.
SEVEN HILLS OH
44131-4442
US

V. Phone/Fax

Practice location:
  • Phone: 216-642-7373
  • Fax: 216-642-7383
Mailing address:
  • Phone: 216-642-7373
  • Fax: 216-642-7383

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number State

VIII. Authorized Official

Name: DR. ROBERT J. GLOSIK
Title or Position: MANAGING PARTNER
Credential: O.D.
Phone: 216-475-7373