=====================================================
General NPI Number Information
=====================================================
NPI Number | 1023389590
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | DR HOWARD S GLAZER CONSULTING LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/15/2012
-----------------------------------------------------
Last Update Date | 01/15/2012
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 264 BEECHWOOD DR
-----------------------------------------------------
City | PARAMUS
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 07652-3303
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 201-599-0660
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 264 BEECHWOOD DR
-----------------------------------------------------
City | PARAMUS
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 07652-3303
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRES
-----------------------------------------------------
Name | DR. HOWARD STEVEN GLAZER
-----------------------------------------------------
Credential | DDS
-----------------------------------------------------
Telephone | 201-599-0660
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 332900000X
-----------------------------------------------------
Taxonomy Name | Non-Pharmacy Dispensing Site
-----------------------------------------------------
License Number | 1
-----------------------------------------------------
License Number State | NJ
-----------------------------------------------------