Provider Demographics
NPI:1699932343
Name:GLASOFER, SIDNEY (MD)
Entity type:Individual
Prefix:DR
First Name:SIDNEY
Middle Name:
Last Name:GLASOFER
Suffix:
Gender:M
Credentials:MD
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Other - Credentials:
Mailing Address - Street 1:PO BOX 416457
Mailing Address - Street 2:PRACTICE ASSOCIATES MEDICAL GROUP
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02241-6457
Mailing Address - Country:US
Mailing Address - Phone:973-656-6280
Mailing Address - Fax:973-290-7495
Practice Address - Street 1:571 CENTRAL AVE STE 115
Practice Address - Street 2:ASSOCIATES INCARDIOVASCULAR DISEASE, LLC
Practice Address - City:NEW PROVIDENCE
Practice Address - State:NJ
Practice Address - Zip Code:07974-1547
Practice Address - Country:US
Practice Address - Phone:908-464-4200
Practice Address - Fax:908-464-1332
Is Sole Proprietor?:No
Enumeration Date:2008-05-20
Last Update Date:2013-05-09
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY239426207RC0000X
NJ25MA08526500207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0267813Medicaid
NJ156596U77Medicare PIN