Provider Demographics
NPI:1750717963
Name:GLASSMAN EYE LLC
Entity type:Organization
Organization Name:GLASSMAN EYE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:GLASSMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:201-836-0888
Mailing Address - Street 1:185 CEDAR LN
Mailing Address - Street 2:SUITE L4
Mailing Address - City:TEANECK
Mailing Address - State:NJ
Mailing Address - Zip Code:07666-4316
Mailing Address - Country:US
Mailing Address - Phone:201-836-0888
Mailing Address - Fax:201-836-6662
Practice Address - Street 1:820 FLATBUSH AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11226-3102
Practice Address - Country:US
Practice Address - Phone:201-836-0888
Practice Address - Fax:201-836-6662
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-19
Last Update Date:2013-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY158955-1261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
Provider Identifiers
StateIdentifier IDID TypeIssuer
C55471Medicare UPIN