MEDICARE: GEORGE N GLOSIK ROBERT J GLOSIK

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1356349930
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GEORGE N GLOSIK ROBERT J GLOSIK

Provider Business Mailing Address
First Line	:	7305 BROADVIEW RD.
Second Line	:
City	:	SEVEN HILLS
State	:	OH
Zip	:	44131-4442
Country	:	US
Telephone Number	:	216-642-7373
Fax Number	:	216-642-7383

Provider Business Practice Location Address
First Line	:	7305 BROADVIEW RD.
Second Line	:
City	:	SEVEN HILLS
State	:	OH
Zip	:	44131-4442
Country	:	US
Telephone Number	:	216-642-7373
Fax Number	:	216-642-7383

Authorized Official
Title or Position	:	MANAGING PARTNER
Name	:	DR. ROBERT J. GLOSIK
Credential	:	O.D.
Telephone Number	:	216-475-7373

Provider Enumeration Date	:	07/08/2005
Last Update Date	:	06/01/2010

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