Provider Demographics
NPI:1528473618
Name:L GLASER AND ASSOCIATES
Entity type:Organization
Organization Name:L GLASER AND ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RNP
Authorized Official - Prefix:
Authorized Official - First Name:LYNNE
Authorized Official - Middle Name:
Authorized Official - Last Name:GLASER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:401-474-5678
Mailing Address - Street 1:93 BRANDON RD
Mailing Address - Street 2:
Mailing Address - City:CRANSTON
Mailing Address - State:RI
Mailing Address - Zip Code:02910-1209
Mailing Address - Country:US
Mailing Address - Phone:401-474-5678
Mailing Address - Fax:
Practice Address - Street 1:93 BRANDON RD
Practice Address - Street 2:
Practice Address - City:CRANSTON
Practice Address - State:RI
Practice Address - Zip Code:02910-1209
Practice Address - Country:US
Practice Address - Phone:401-474-5678
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-26
Last Update Date:2014-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIS99699363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
RINPP25135OtherLICENSE NUMBER
1275520694OtherINDIVIDUAL NPI
S99699Medicare UPIN