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General NPI Number Information
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NPI Number | 1982764288
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Entity Type | Organization
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Legal Business Name | GERALD W. GLASER, O.D. AND ASSOCIATES, INC.
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Dates
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Enumeration Date | 12/10/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 400 BALD HILL RD SUITE 163
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City | WARWICK
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State | RI
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Zip | 02886-1617
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Country | US
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Telephone | 401-738-9866
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Fax | 401-732-7810
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Provider Business Mailing Address
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Address Line | 400 BALD HILL RD SUITE 163
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City | WARWICK
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State | RI
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Zip | 02886-1617
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Country | US
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Telephone | 401-738-9866
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Fax | 401-732-7810
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Authorized Official
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Title or Position | DIRECTOR
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Name | GERALD W. GLASER
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Credential | O.D.
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Telephone | 401-738-9866
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | ODTA00466
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License Number State | RI
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