Provider Demographics
NPI:1104985506
Name:LEONARD H. GLASSMAN O.D., P.C.
Entity type:Organization
Organization Name:LEONARD H. GLASSMAN O.D., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:
Authorized Official - Last Name:GLASSMAN
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:718-492-7500
Mailing Address - Street 1:PO BOX 76
Mailing Address - Street 2:
Mailing Address - City:CEDARHURST
Mailing Address - State:NY
Mailing Address - Zip Code:11516-0076
Mailing Address - Country:US
Mailing Address - Phone:718-492-7500
Mailing Address - Fax:
Practice Address - Street 1:6834 3RD AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11220-5803
Practice Address - Country:US
Practice Address - Phone:718-492-7500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-08
Last Update Date:2012-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYTUV005740-1152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01781855Medicaid
NY1982639852OtherNPI NANCY
NY00330492Medicaid
NYU63316Medicare UPIN
NY0330450001Medicare NSC
NY01781855Medicaid