Provider Demographics
NPI:1780746313
Name:GLASER, DAVID JAY (LCSW)
Entity type:Individual
Prefix:MR
First Name:DAVID
Middle Name:JAY
Last Name:GLASER
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 POST RD STE M1
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:NJ
Mailing Address - Zip Code:07436-1618
Mailing Address - Country:US
Mailing Address - Phone:201-337-9165
Mailing Address - Fax:
Practice Address - Street 1:9 POST RD STE M1
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:NJ
Practice Address - Zip Code:07436-1618
Practice Address - Country:US
Practice Address - Phone:201-337-9165
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SCO12750001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical