Provider Demographics
NPI:1376597294
Name:STUART A GLASSER MD PC
Entity Type:Organization
Organization Name:STUART A GLASSER MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:STUART
Authorized Official - Middle Name:A
Authorized Official - Last Name:GLASSER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:724-832-1800
Mailing Address - Street 1:916 GREEN ST
Mailing Address - Street 2:
Mailing Address - City:GREENSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:15601-4135
Mailing Address - Country:US
Mailing Address - Phone:724-832-1800
Mailing Address - Fax:724-832-1742
Practice Address - Street 1:916 GREEN ST
Practice Address - Street 2:
Practice Address - City:GREENSBURG
Practice Address - State:PA
Practice Address - Zip Code:15601-4135
Practice Address - Country:US
Practice Address - Phone:724-832-1800
Practice Address - Fax:724-832-1742
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-22
Last Update Date:2010-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD20603E207NS0135X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207NS0135XAllopathic & Osteopathic PhysiciansDermatologyProcedural DermatologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA906440Medicare ID - Type UnspecifiedGROUP MEDICARE NUMBER