MEDICARE: ROBERT M GLASSBERG MD

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	2085R0202X	Diagnostic Radiology Physician	25MA05926200	NJ

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	P00847770	OTHER	NJ	RAILROAD MEDICARE
2	P00793703	OTHER	NJ	RAILROAD MEDICARE
3	300081003	OTHER	NJ	RAILROAD MEDICARE

Other Identifiers

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

General Provider Information

NPI Number	:	1982717187
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROBERT M GLASSBERG MD

Provider Business Mailing Address
First Line	:	72 W JIMMIE LEEDS RD
Second Line	:	SUITE 1100
City	:	GALLOWAY
State	:	NJ
Zip	:	08205-9406
Country	:	US
Telephone Number	:	609-677-9729
Fax Number	:	609-652-7153

Provider Business Practice Location Address
First Line	:	4450 BLACK HORSE PIKE
Second Line	:	STE 3972
City	:	MAYS LANDING
State	:	NJ
Zip	:	08330-3107
Country	:	US
Telephone Number	:	609-677-9729
Fax Number	:	609-652-6270

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/15/2006
Last Update Date	:	12/11/2018

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Directions to “ ROBERT M GLASSBERG MD” Practice Location

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