Provider Demographics
NPI:1366557274
Name:GLASSBAND, STEVEN I (OD)
Entity type:Individual
Prefix:
First Name:STEVEN
Middle Name:I
Last Name:GLASSBAND
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:72 PRINCETON HIGHTSTOWN RD
Mailing Address - Street 2:
Mailing Address - City:EAST WINDSOR
Mailing Address - State:NJ
Mailing Address - Zip Code:08520-1935
Mailing Address - Country:US
Mailing Address - Phone:609-918-9808
Mailing Address - Fax:609-918-9828
Practice Address - Street 1:72 PRINCETON HIGHTSTOWN RD
Practice Address - Street 2:
Practice Address - City:EAST WINDSOR
Practice Address - State:NJ
Practice Address - Zip Code:08520-1935
Practice Address - Country:US
Practice Address - Phone:609-918-9808
Practice Address - Fax:609-918-9828
Is Sole Proprietor?:No
Enumeration Date:2006-08-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ270A00562200152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
U77593Medicare UPIN
NJ032790Medicare ID - Type Unspecified