Provider Demographics
NPI:1942497219
Name:QUEEN CITY CARDIOTHORACIC SURG
Entity Type:Organization
Organization Name:QUEEN CITY CARDIOTHORACIC SURG
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:S
Authorized Official - Last Name:GLASER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:513-794-9500
Mailing Address - Street 1:10496 MONTGOMERY RD
Mailing Address - Street 2:#101
Mailing Address - City:CINTI
Mailing Address - State:OH
Mailing Address - Zip Code:45242
Mailing Address - Country:US
Mailing Address - Phone:513-794-9500
Mailing Address - Fax:513-745-8282
Practice Address - Street 1:10496 MONTGOMERY RD
Practice Address - Street 2:#101
Practice Address - City:CINTI
Practice Address - State:OH
Practice Address - Zip Code:45242
Practice Address - Country:US
Practice Address - Phone:513-794-9500
Practice Address - Fax:513-745-8282
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-01
Last Update Date:2007-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)Group - Single Specialty