Individual
GLAUCO RADOSLOVICH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
20 PROSPECT AVE, STE 701, HACKENSACK, NJ 07601-1997
(201) 996-2997
(201) 996-2571
Mailing address
100 WINSTON DR, 11CS, CLIFFSIDE PK, NJ 07010-3240
(201) 224-9845
Taxonomy
Speciality
Code
Description
License number
State
207RC0001X
Clinical Cardiac Electrophysiology Physician
Primary
25MA0575800
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000120940
GHI HMO
NJ
05
—
02868633
—
NY
01
—
2101549
GHI PPO
NJ
01
—
2307025
AETNA HMO
NJ
01
—
4545953
AETNA PPO
NJ
05
—
5387906
—
NJ
01
—
81061
AMERIGROUP
NJ
01
—
BS504
OXFORD
NJ
Enumeration date
03/03/2006
Last updated
07/10/2008
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