Edward a. Gluck MD PC

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

124359 Issued in NY

Legal business name

EDWARD A. GLUCK MD PC

Practice address

112-03 Queens Blvd.
Suite 206
Forest Hills, NY 11375

Phone

(718) 263-3737

Fax

(718) 263-1156

NPI assigned

Feb 14, 2012

Organization subpart

No

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

Authorized official

Name

Edward A. Gluck, M.D.

Title

President

Phone

(718) 263-3737

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1329177600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1329177600000",
    "number": "1407129091",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "112-03 QUEENS BLVD.",
            "address_2": "SUITE 206",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "11375",
            "telephone_number": "718-263-3737",
            "fax_number": "718-263-1156"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "112-03 QUEENS BLVD.",
            "address_2": "SUITE 206",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "11375",
            "telephone_number": "718-263-3737",
            "fax_number": "718-263-1156"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDWARD A. GLUCK MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-02-14",
        "last_updated": "2012-02-14",
        "status": "A",
        "authorized_official_last_name": "GLUCK",
        "authorized_official_first_name": "EDWARD",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "718-263-3737",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": "NY",
            "license": "124359",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00277183",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Ophthalmology Physician in Forest Hills, NY
• Providers in Forest Hills, NY by specialty
• Ophthalmology Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.