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General NPI Number Information
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NPI Number | 1700931359
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Entity Type | Organization
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Legal Business Name | JORDAN B. GLASER M.D.P.C
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Dates
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Enumeration Date | 01/24/2007
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Last Update Date | 06/05/2020
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Provider Practice Location Address
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Address Line | 1408 RICHMOND RD
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City | STATEN ISLAND
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State | NY
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Zip | 10304-2312
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Country | US
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Telephone | 718-816-3362
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Fax | 718-979-4650
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Provider Business Mailing Address
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Address Line | 1408 RICHMOND RD
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City | STATEN ISLAND
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State | NY
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Zip | 10304-2312
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Country | US
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Telephone | 718-816-3362
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Fax | 718-979-4650
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Authorized Official
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Title or Position | INFECTIOUS DISEASE SPECIALIST
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Name | JORDAN BARRY GLASER
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Credential | M.D.P.C.
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Telephone | 718-816-3362
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RI0200X
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Taxonomy Name | Infectious Disease Physician
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License Number |
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License Number State |
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