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Organization

GLASS & INSERRA, M.D P.C.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
KENNETH S GLASS M.D. (PRESIDENT)
(631) 360-2200
Entity
Organization

Contact information

Practice address
309 MIDDLE COUNTRY RD, SUITE 101, SMITHTOWN, NY 11787-2844
(631) 360-2200
(631) 360-1328
Mailing address
309 MIDDLE COUNTRY RD, SUITE 101, SMITHTOWN, NY 11787-2844
(631) 360-2200
(631) 360-1328

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
116939
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1710156500
NY
01
CF3379
RR MEDICARE
NY
Enumeration date
02/26/2008
Last updated
09/02/2008
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