Provider Demographics
NPI:1366454555
Name:GLUCK, ROBERT I (MD)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:I
Last Name:GLUCK
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Gender:M
Credentials:MD
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Mailing Address - Street 1:410 LAKEVILLE RD
Mailing Address - Street 2:SUITE 310
Mailing Address - City:NEW HYDE PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11042-1101
Mailing Address - Country:US
Mailing Address - Phone:516-280-5844
Mailing Address - Fax:516-280-5768
Practice Address - Street 1:410 LAKEVILLE RD
Practice Address - Street 2:SUITE 310
Practice Address - City:NEW HYDE PARK
Practice Address - State:NY
Practice Address - Zip Code:11042-1101
Practice Address - Country:US
Practice Address - Phone:516-280-5844
Practice Address - Fax:516-280-5768
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-13
Last Update Date:2008-01-05
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Provider Licenses
StateLicense IDTaxonomies
NY155436207XS0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0106XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYE50448Medicare UPIN