Individual
MARK S GLASSMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
19 BRADHURST AVE, STE 1400, HAWTHORNE, NY 10532-2140
(914) 594-4610
(914) 594-4392
Mailing address
19 BRADHURST AVE, STE 1400, HAWTHORNE, NY 10532-2140
(914) 594-4610
(914) 594-4392
Taxonomy
Speciality
Code
Description
License number
State
2080P0206X
Pediatric Gastroenterology Physician
Primary
157811
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001242700
—
CT
05
—
00867643
—
NY
Enumeration date
07/28/2005
Last updated
09/26/2008
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