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Individual

DR. JEROME B GLASSMITH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DPM

Contact information

Practice address
4105 31ST AVENUE, ASTORIA, NY 11103-3462
(718) 278-8020
(718) 278-8599
Mailing address
4105 31ST AVENUE, ASTORIA, NY 11103-3462
(718) 278-8020
(718) 278-8599

Taxonomy

Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
2400
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
002400A39
HEALTHFIRST
NY
01
0086040
GHI
NY
05
1101493690
NY
01
177233
ELDERPLAN
NY
01
1870
MAGNAHEALTH
NY
01
24409
VITRA
NY
01
36528P
HIP
NY
01
4809110772
RR MCR
NY
01
4C4625
PHS
NY
01
825983
PENNSYLVANIA BLUE SHIELD
NY
01
ACCESS 931365
HEALTHNET
NY
01
GJ2400
ATLANTIS HEALTH
NY
01
P030002400NY01
ANTHEM 6450
NY
01
P27721
BLUE CROSS BLUE SHIELD
NY
01
P463339
OXFORD
NY
01
P62577571
MULTIPLAN
NY
Enumeration date
03/05/2007
Last updated
07/08/2007
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