Provider Demographics
NPI:1588810634
Name:GLASER, DAVID ARI (MS CCC-A)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:ARI
Last Name:GLASER
Suffix:
Gender:M
Credentials:MS CCC-A
Other - Prefix:
Other - First Name:DAVID
Other - Middle Name:ARI
Other - Last Name:GLASER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MS CCC-A
Mailing Address - Street 1:300 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:VESTAL
Mailing Address - State:NY
Mailing Address - Zip Code:13850-1545
Mailing Address - Country:US
Mailing Address - Phone:607-786-9522
Mailing Address - Fax:607-786-9523
Practice Address - Street 1:300 MAIN ST
Practice Address - Street 2:
Practice Address - City:VESTAL
Practice Address - State:NY
Practice Address - Zip Code:13850-1545
Practice Address - Country:US
Practice Address - Phone:607-786-9522
Practice Address - Fax:607-786-9523
Is Sole Proprietor?:No
Enumeration Date:2008-08-08
Last Update Date:2008-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY002018-1231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist