Provider Demographics
NPI:1972591089
Name:GLOZMAN, ALEXANDR JOSIFOVICH (MD)
Entity Type:Individual
Prefix:
First Name:ALEXANDR
Middle Name:JOSIFOVICH
Last Name:GLOZMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:100 PARK ST
Mailing Address - Street 2:GLENS FALLS HOSPITAL
Mailing Address - City:GLENS FALLS
Mailing Address - State:NY
Mailing Address - Zip Code:12801-4413
Mailing Address - Country:US
Mailing Address - Phone:518-926-3210
Mailing Address - Fax:518-926-3215
Practice Address - Street 1:100 PARK ST
Practice Address - Street 2:GLENS FALLS HOSPITAL
Practice Address - City:GLENS FALLS
Practice Address - State:NY
Practice Address - Zip Code:12801-4413
Practice Address - Country:US
Practice Address - Phone:518-926-3210
Practice Address - Fax:518-926-3215
Is Sole Proprietor?:No
Enumeration Date:2005-10-12
Last Update Date:2012-06-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY2092152084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYP00033419OtherRR MEDICARE
NYP00033419OtherRR MEDICARE
NYDD6475Medicare PIN
H08951Medicare UPIN