Provider Demographics
NPI:1649245978
Name:GLASSMAN EYE ASSOCIATES PA
Entity Type:Organization
Organization Name:GLASSMAN EYE ASSOCIATES PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:M
Authorized Official - Last Name:GLASSMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:201-836-0888
Mailing Address - Street 1:185 CEDAR LANE
Mailing Address - Street 2:L-4
Mailing Address - City:TEANECK
Mailing Address - State:NJ
Mailing Address - Zip Code:07666
Mailing Address - Country:US
Mailing Address - Phone:201-836-0888
Mailing Address - Fax:201-836-6662
Practice Address - Street 1:185 CEDAR LANE
Practice Address - Street 2:L-4
Practice Address - City:TEANECK
Practice Address - State:NJ
Practice Address - Zip Code:07666
Practice Address - Country:US
Practice Address - Phone:201-836-0888
Practice Address - Fax:201-836-6662
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-21
Last Update Date:2008-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ4952610001Medicare NSC
NJ527204Medicare PIN