Provider Demographics
NPI:1588663652
Name:GLASSMAN, MORRIS I (MD)
Entity Type:Individual
Prefix:
First Name:MORRIS
Middle Name:I
Last Name:GLASSMAN
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 1:1940 COMMERCE ST
Mailing Address - Street 2:
Mailing Address - City:YORKTOWN HEIGHTS
Mailing Address - State:NY
Mailing Address - Zip Code:10598-4428
Mailing Address - Country:US
Mailing Address - Phone:914-962-5506
Mailing Address - Fax:914-962-0877
Practice Address - Street 1:1940 COMMERCE ST
Practice Address - Street 2:
Practice Address - City:YORKTOWN HEIGHTS
Practice Address - State:NY
Practice Address - Zip Code:10598-4428
Practice Address - Country:US
Practice Address - Phone:914-962-5506
Practice Address - Fax:914-962-0877
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY108613174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY633301Medicare ID - Type Unspecified
NYB17359Medicare UPIN