Provider Demographics
NPI:1700531563
Name:GLASBY, CEDRIC RAY
Entity Type:Individual
Prefix:
First Name:CEDRIC
Middle Name:RAY
Last Name:GLASBY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 MICHIGAN AVE NE APT 23
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20017-1026
Mailing Address - Country:US
Mailing Address - Phone:202-239-9585
Mailing Address - Fax:
Practice Address - Street 1:70 I ST SE APT 221
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20003-4807
Practice Address - Country:US
Practice Address - Phone:202-271-2996
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-19
Last Update Date:2022-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DC3747P1801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant