Provider Demographics
NPI:1609859800
Name:GLASSMAN, JOEL M (MD)
Entity type:Individual
Prefix:DR
First Name:JOEL
Middle Name:M
Last Name:GLASSMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:709 S 5TH ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19147-3043
Mailing Address - Country:US
Mailing Address - Phone:215-925-3133
Mailing Address - Fax:215-925-4362
Practice Address - Street 1:201 OLD YORK RD
Practice Address - Street 2:SUITE 205
Practice Address - City:JENKINTOWN
Practice Address - State:PA
Practice Address - Zip Code:19046-3200
Practice Address - Country:US
Practice Address - Phone:215-885-6767
Practice Address - Fax:215-885-5297
Is Sole Proprietor?:No
Enumeration Date:2005-11-22
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PAMD022768E207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAC33731Medicare UPIN
PA0417879FTMMedicare ID - Type Unspecified