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General NPI Number Information
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NPI Number | 1750717963
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Entity Type | Organization
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Legal Business Name | GLASSMAN EYE LLC
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Dates
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Enumeration Date | 09/19/2013
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Last Update Date | 09/19/2013
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Provider Practice Location Address
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Address Line | 820 FLATBUSH AVE
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City | BROOKLYN
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State | NY
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Zip | 11226-3102
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Country | US
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Telephone | 201-836-0888
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Fax | 201-836-6662
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Provider Business Mailing Address
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Address Line | 185 CEDAR LN SUITE L4
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City | TEANECK
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State | NJ
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Zip | 07666-4316
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Country | US
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Telephone | 201-836-0888
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Fax | 201-836-6662
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Authorized Official
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Title or Position | OWNER
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Name | DR. RONALD MICHAEL GLASSMAN
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Credential | MD
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Telephone | 201-836-0888
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number | 158955-1
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License Number State | NY
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