Organization
EDWARD A. GLUCK MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EDWARD A. GLUCK M.D. (PRESIDENT)
(718) 263-3737
Entity
Organization
Contact information
Practice address
112-03 QUEENS BLVD., SUITE 206, FOREST HILLS, NY 11375
(718) 263-3737
(718) 263-1156
Mailing address
112-03 QUEENS BLVD., SUITE 206, FOREST HILLS, NY 11375
(718) 263-3737
(718) 263-1156
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
124359
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00277183
—
NY
Enumeration date
02/14/2012
Last updated
02/14/2012
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