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Individual

MR. MICHAEL WARREN GLAZER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PHD

Contact information

Practice address
3594 EAST TREMONT AVENUE, SUITE 210, BRONX, NY 10465-2032
(718) 792-4178
(718) 792-2496
Mailing address
3594 EAST TREMONT AVENUE, SUITE 210, BRONX, NY 10465-2032
(718) 792-4178
(718) 792-2496

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
004412
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
00441268
HIP
01
1053460
BEACON
01
147475
VALUE OPTIONS
01
A2367
LOCAL 1199
01
P821454
OXFORD
01
V1849
EMPIRE
01
VF037
EMPIRE
Enumeration date
10/23/2006
Last updated
07/08/2007
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