Provider Demographics
NPI:1083745947
Name:GLASS, ELIZABETH CAREY (MD)
Entity Type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:CAREY
Last Name:GLASS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:7 DANDY DR
Mailing Address - Street 2:
Mailing Address - City:COS COB
Mailing Address - State:CT
Mailing Address - Zip Code:06807-2204
Mailing Address - Country:US
Mailing Address - Phone:917-796-9551
Mailing Address - Fax:
Practice Address - Street 1:41 E POST RD
Practice Address - Street 2:DEPT. OF RADIOLOGY
Practice Address - City:WHITE PLAINS
Practice Address - State:NY
Practice Address - Zip Code:10601-4607
Practice Address - Country:US
Practice Address - Phone:914-681-2929
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-09
Last Update Date:2015-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY225249-12085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology