Provider Demographics
NPI:1710067954
Name:GLASSER, STEPHEN LAWRENCE (OD)
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:LAWRENCE
Last Name:GLASSER
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:900 17TH ST NW
Mailing Address - Street 2:SUITE 400
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20006
Mailing Address - Country:US
Mailing Address - Phone:202-223-3530
Mailing Address - Fax:202-223-9748
Practice Address - Street 1:900 17TH ST NW
Practice Address - Street 2:SUITE 400
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20006
Practice Address - Country:US
Practice Address - Phone:202-223-3530
Practice Address - Fax:202-223-9748
Is Sole Proprietor?:No
Enumeration Date:2006-10-16
Last Update Date:2017-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCOP421152WC0802X, 152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
No152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC0647270Medicare ID - Type UnspecifiedMEDICARE PROVIDER NO.