Provider Demographics
NPI:1982728820
Name:DR. MARTIN GLASSMAN, OPTOMETRIST INC.
Entity Type:Organization
Organization Name:DR. MARTIN GLASSMAN, OPTOMETRIST INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:
Authorized Official - Last Name:GLASSAMNN
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:513-771-8120
Mailing Address - Street 1:11503 SPRINGFIELD PIKE
Mailing Address - Street 2:SUITE 230
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45246-3508
Mailing Address - Country:US
Mailing Address - Phone:513-771-8120
Mailing Address - Fax:
Practice Address - Street 1:11503 SPRINGFIELD PIKE
Practice Address - Street 2:SUITE 230
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45246-3508
Practice Address - Country:US
Practice Address - Phone:513-771-8120
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-18
Last Update Date:2007-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3737-T786152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH141515OtherEYEMED
OH5137718120OtherVISION SERVICE PLAN
OHGL0628921OtherHUMANA
OHGL0628921OtherAETNA
OH2201206OtherUNITED HEALTH CARE
OH000000010507OtherANTHEM
OH280642088002OtherMEDICAL MUTUAL
OHGL0628921OtherHEALTHSPAN
OH0064068Medicaid
OH280642088001OtherMEDICAL MUTUAL
OH3256OtherDAVIS VISION
OHGL0628921OtherCIGNA
OH000000010507OtherANTHEM
OHT-81997Medicare UPIN