Provider Demographics
NPI:1982764288
Name:GERALD W. GLASER, O.D. AND ASSOCIATES, INC.
Entity Type:Organization
Organization Name:GERALD W. GLASER, O.D. AND ASSOCIATES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:GERALD
Authorized Official - Middle Name:W
Authorized Official - Last Name:GLASER
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:401-738-9866
Mailing Address - Street 1:400 BALD HILL RD
Mailing Address - Street 2:SUITE 163
Mailing Address - City:WARWICK
Mailing Address - State:RI
Mailing Address - Zip Code:02886-1617
Mailing Address - Country:US
Mailing Address - Phone:401-738-9866
Mailing Address - Fax:401-732-7810
Practice Address - Street 1:400 BALD HILL RD
Practice Address - Street 2:SUITE 163
Practice Address - City:WARWICK
Practice Address - State:RI
Practice Address - Zip Code:02886-1617
Practice Address - Country:US
Practice Address - Phone:401-738-9866
Practice Address - Fax:401-732-7810
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-10
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIODTA00466152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI2200385OtherUNITED HEALTHCARE
RIRI0466OtherEYEMED VISION CARE
RI402684OtherBLUE CHIP HEALTH PLAN
RI7834-4OtherBLUE CROSS & BLUE SHIELD
RI2200385OtherUNITED HEALTHCARE