Individual
GUY FREDRICK GLASS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
145 E 15TH ST, SUITE 1F, NEW YORK, NY 10003-3531
(212) 982-6209
Mailing address
145 E 15TH ST, SUITE 1F, NEW YORK, NY 10003-3531
(212) 982-6209
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
041970E
PA
2084P0800X
Psychiatry Physician
Primary
185314
NY
2084P0800X
Psychiatry Physician
25MA07356300
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01562138
—
NY
Enumeration date
08/10/2005
Last updated
12/28/2009
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