Provider Demographics
NPI:1104801174
Name:GLASSMAN, BEN A (MD)
Entity type:Individual
Prefix:
First Name:BEN
Middle Name:A
Last Name:GLASSMAN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:22 SAW MILL RIVER RD
Mailing Address - Street 2:2ND. FLOOR
Mailing Address - City:HAWTHORNE
Mailing Address - State:NY
Mailing Address - Zip Code:10532-1533
Mailing Address - Country:US
Mailing Address - Phone:914-593-1659
Mailing Address - Fax:914-593-1790
Practice Address - Street 1:19 BRADHURST AVE
Practice Address - Street 2:SUITE 2400
Practice Address - City:HAWTHORNE
Practice Address - State:NY
Practice Address - Zip Code:10532-2140
Practice Address - Country:US
Practice Address - Phone:914-593-8850
Practice Address - Fax:914-594-3747
Is Sole Proprietor?:No
Enumeration Date:2005-12-13
Last Update Date:2008-07-24
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Provider Licenses
StateLicense IDTaxonomies
NY128561208000000X
CT018597208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY000000092201OtherGHI HMO
NY0562451OtherAETNA(HMO) PRIMARY CARE
NY662Z61OtherBLUE CROSS PPO
NY133884168OtherPOMCO
NY128561-8WOtherWORKERS COMPENSATION
NY128561OtherCONNECTICARE
NY133884168OtherHORIZON HEALTHCARE OF NY
NY662Z61OtherSWSCHP
NY133884168OtherPHCS
NY2695454OtherGHI PPO
NY662Z61OtherEMPIRE BLUE CROSS HMO
NYWP187OtherOXFORD
NY4237422OtherAETNA (NON HMO)
NYA99032Medicare UPIN