Provider Demographics
NPI:1790925212
Name:GLASSMAN, DEBRA CARYL (DDS)
Entity Type:Individual
Prefix:DR
First Name:DEBRA
Middle Name:CARYL
Last Name:GLASSMAN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:DEBRA
Other - Middle Name:CARYL
Other - Last Name:LANGSNER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:160 WEST END AVE
Mailing Address - Street 2:1R
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10023
Mailing Address - Country:US
Mailing Address - Phone:212-787-4860
Mailing Address - Fax:212-787-9238
Practice Address - Street 1:160 WEST END AVENUE
Practice Address - Street 2:1R
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10023
Practice Address - Country:US
Practice Address - Phone:212-787-4860
Practice Address - Fax:212-787-9238
Is Sole Proprietor?:No
Enumeration Date:2009-02-24
Last Update Date:2009-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY040929122300000X
NY0384791122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist