Provider Demographics
NPI:1154329944
Name:GLASSMIRE, WILLIAM J (PAC)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:J
Last Name:GLASSMIRE
Suffix:
Gender:M
Credentials:PAC
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:7515 STENTON AVE
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19150-3710
Mailing Address - Country:US
Mailing Address - Phone:267-335-5264
Mailing Address - Fax:267-335-5273
Practice Address - Street 1:6122 TORRESDALE AVE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19135-3718
Practice Address - Country:US
Practice Address - Phone:215-338-6677
Practice Address - Fax:215-338-9935
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-07-14
Last Update Date:2018-12-19
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PAOA000251L363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant