Provider Demographics
NPI:1558436113
Name:GLASGOLD, ROBERT ALEXANDER (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:ALEXANDER
Last Name:GLASGOLD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 VALLEY FORGE DR
Mailing Address - Street 2:
Mailing Address - City:EAST BRUNSWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08816-3275
Mailing Address - Country:US
Mailing Address - Phone:732-238-4004
Mailing Address - Fax:
Practice Address - Street 1:31 RIVER RD
Practice Address - Street 2:
Practice Address - City:HIGHLAND PARK
Practice Address - State:NJ
Practice Address - Zip Code:08904-1731
Practice Address - Country:US
Practice Address - Phone:732-846-6540
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA 0735182086S0122X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive Surgery