Provider Demographics
NPI:1740022870
Name:GLASSMAN, ERIC H
Entity type:Individual
Prefix:
First Name:ERIC
Middle Name:H
Last Name:GLASSMAN
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 1:13249 OLD FLORIDA CIR
Mailing Address - Street 2:
Mailing Address - City:HUDSON
Mailing Address - State:FL
Mailing Address - Zip Code:34669-2891
Mailing Address - Country:US
Mailing Address - Phone:727-284-5963
Mailing Address - Fax:
Practice Address - Street 1:13249 OLD FLORIDA CIR
Practice Address - Street 2:
Practice Address - City:HUDSON
Practice Address - State:FL
Practice Address - Zip Code:34669-2891
Practice Address - Country:US
Practice Address - Phone:727-284-5963
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-10
Last Update Date:2024-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician