Individual
MRS. ALISA SUZANNE GLICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
P.T.
Contact information
Practice address
1 SHELDON PL, COMMACK, NY 11725-3216
(631) 499-0414
(631) 499-0414
Mailing address
1 SHELDON PL, COMMACK, NY 11725-3216
(631) 499-0414
(631) 499-0414
Taxonomy
Speciality
Code
Description
License number
State
2251P0200X
Pediatric Physical Therapist
Primary
020232
NY
Other
Enumeration date
11/17/2006
Last updated
07/08/2007
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