Provider Demographics
NPI:1699810465
Name:GLASER-ZAKEM, LORAINE J (MD)
Entity Type:Individual
Prefix:DR
First Name:LORAINE
Middle Name:J
Last Name:GLASER-ZAKEM
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4440 RED BANK RD
Mailing Address - Street 2:SUITE 110
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45227-2176
Mailing Address - Country:US
Mailing Address - Phone:513-564-1366
Mailing Address - Fax:513-564-1367
Practice Address - Street 1:4440 RED BANK RD
Practice Address - Street 2:SUITE 110
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45227-2176
Practice Address - Country:US
Practice Address - Phone:513-564-1366
Practice Address - Fax:513-564-1367
Is Sole Proprietor?:No
Enumeration Date:2007-02-20
Last Update Date:2014-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH054094207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY64953714Medicaid
OH0687547Medicaid
KY64953714Medicaid