Provider Demographics
NPI:1225271711
Name:J.L.GLASHOW M.D.,P.C.
Entity Type:Organization
Organization Name:J.L.GLASHOW M.D.,P.C.
Other - Org Name:JOM
Other - Org Type:Other Name
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:CARRIN
Authorized Official - Middle Name:M
Authorized Official - Last Name:MCSORLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:914-669-6085
Mailing Address - Street 1:159 E 74TH ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10021-3249
Mailing Address - Country:US
Mailing Address - Phone:212-794-5096
Mailing Address - Fax:212-570-1507
Practice Address - Street 1:737 PARK AVE STE 1C
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021-4256
Practice Address - Country:US
Practice Address - Phone:212-794-5096
Practice Address - Fax:212-570-1507
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-13
Last Update Date:2009-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY163027OtherWORKERS COPENSATIO NUMBER