Provider Demographics
NPI:1457160137
Name:GLASER, CYRIL HENRY (PT, DPT)
Entity type:Individual
Prefix:
First Name:CYRIL
Middle Name:HENRY
Last Name:GLASER
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3305 CALLE CUERVO NW APT 1224
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87114-9241
Mailing Address - Country:US
Mailing Address - Phone:630-407-4180
Mailing Address - Fax:
Practice Address - Street 1:8325 2ND ST NW STE B
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87114-1013
Practice Address - Country:US
Practice Address - Phone:505-266-3655
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-06
Last Update Date:2025-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMPT-2024-0323225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist