| Jordan B. Glaser M.d.p.c | |
|
1408 Richmond Rd Staten Island NY 10304-2312 | |
| (718) 816-3362 | |
| (718) 979-4650 |
| Full Name | Jordan B. Glaser M.d.p.c |
|---|---|
| Speciality | Internal Medicine |
| Location | 1408 Richmond Rd, Staten Island, New York |
| Authorized Official Name and Position | Jordan Barry Glaser (INFECTIOUS DISEASE SPECIALIST) |
| Authorized Official Contact | 7188163362 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Jordan B. Glaser M.d.p.c 1408 Richmond Rd Staten Island NY 10304-2312 Ph: (718) 816-3362 | Jordan B. Glaser M.d.p.c 1408 Richmond Rd Staten Island NY 10304-2312 Ph: (718) 816-3362 |
| NPI Number | 1700931359 |
|---|---|
| Provider Enumeration Date | 01/24/2007 |
| Last Update Date | 06/05/2020 |
| Medicare PECOS PAC ID | 2163314055 |
|---|---|
| Medicare Enrollment ID | O20040325001732 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700931359 | NPI | - | NPPES |
| 02550172 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RI0200X | Internal Medicine - Infectious Disease | (* (Not Available)) | Primary |
| Provider Name | Jordan B Glaser |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1821084732 PECOS PAC ID: 2466434436 Enrollment ID: I20040603000399 |
| Provider Name | Adedayo Adedeji |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1285621698 PECOS PAC ID: 0042408171 Enrollment ID: I20101216000225 |
| Provider Name | Mohsena F Amin |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1346540986 PECOS PAC ID: 1759560410 Enrollment ID: I20110126001137 |
| Provider Name | Neville Mobarakai |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1639166309 PECOS PAC ID: 3375723067 Enrollment ID: I20110214000127 |
| Provider Name | Stephen J Maslak |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1083931497 PECOS PAC ID: 4183872609 Enrollment ID: I20120907000023 |
| Provider Name | Allison M Glaser |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1740522580 PECOS PAC ID: 4082977236 Enrollment ID: I20180420002297 |
| Provider Name | Vincent Bruzola Dechavez |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1518352244 PECOS PAC ID: 2163712506 Enrollment ID: I20200731001300 |
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