Individual provider Active NPI

Eric Glasofer, M.D., PHD

  • Specialist
  • Voorhees, NJ
National Provider Identifier
1033176136
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
25MA04097700 Issued in NJ
Practice address
1000 White Horse Rd
Suite 904
Voorhees, NJ 08043-4406
Phone
(856) 772-1200
Fax
(856) 772-9674
NPI assigned
May 1, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 25MA04097700 NJ Primary

Addresses

Primary practice location

1000 White Horse Rd
Suite 904
Voorhees, NJ 08043-4406

Mailing address

1000 White Horse Rd
Suite 904
Voorhees, NJ 08043-4406
Phone (856) 772-1200

Other identifiers 1

IdentifierTypeStateIssuer
4701801MedicaidNJ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041102000336 NJ Practitioner - Allergy/ImmunologyPractitioner - Pediatric Medicine 4880656875

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine, Doctor of Philosophy

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1146441600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1033176136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 WHITE HORSE RD",
            "address_2": "SUITE 904",
            "city": "VOORHEES",
            "state": "NJ",
            "postal_code": "080434406",
            "telephone_number": "856-772-1200",
            "fax_number": "856-772-9674"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 WHITE HORSE RD",
            "address_2": "SUITE 904",
            "city": "VOORHEES",
            "state": "NJ",
            "postal_code": "080434406",
            "telephone_number": "856-772-1200",
            "fax_number": "856-772-9674"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLASOFER",
        "first_name": "ERIC",
        "name_prefix": "Dr.",
        "credential": "M.D., PHD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NJ",
            "license": "25MA04097700",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4701801",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Voorhees, NJ

Sources for this page

Verify at the official NPI Registry.