Provider Demographics
NPI:1538448832
Name:GLASSMAN, ELIZABETH ROSEMOND (AUD)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:ROSEMOND
Last Name:GLASSMAN
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:KATELYN
Other - Middle Name:
Other - Last Name:GLASSMAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:550 1ST AVE
Mailing Address - Street 2:NBV 5E5
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-6402
Mailing Address - Country:US
Mailing Address - Phone:646-501-6905
Mailing Address - Fax:
Practice Address - Street 1:550 1ST AVE
Practice Address - Street 2:NBV 5E5
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-6402
Practice Address - Country:US
Practice Address - Phone:646-501-6905
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-08-04
Last Update Date:2011-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY002361231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist