Healthcare Provider Details

I. General information

NPI: 1760439046
Provider Name (Legal Business Name): LEWIS GLASSER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 05/30/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

593 EDDY ST DEPARTMENT OF PATHOLOGY APC 12
PROVIDENCE RI
02903-4923
US

IV. Provider business mailing address

593 EDDY ST DEPARTMENT OF PATHOLOGY APC 12
PROVIDENCE RI
02903-4923
US

V. Phone/Fax

Practice location:
  • Phone: 401-444-8897
  • Fax: 401-444-8514
Mailing address:
  • Phone: 401-444-8897
  • Fax: 401-444-8514

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207ZH0000X
TaxonomyHematology (Pathology) Physician
License NumberMD8775
License Number StateRI
# 2
Primary TaxonomyN
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License NumberMD8775
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: