Individual
EILEEN S GLICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
333 N OXFORD VALLEY RD, SUITE 510, FAIRLESS HILLS, PA 19030-2624
(215) 785-0145
(215) 785-0161
Mailing address
PO BOX 606, LANGHORNE, PA 19047-0606
(215) 785-0145
(215) 785-0161
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN189785L
PA
367500000X
Certified Registered Nurse Anesthetist
26NJ00195700
NJ
367500000X
Certified Registered Nurse Anesthetist
Primary
RN189785L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
076960RVB
NATIONAL GOVERNMENT SERVICES (NJ EMPIRE)
NJ
01
—
430033948
RAILROAD MEDICARE
PA
Enumeration date
07/13/2006
Last updated
05/11/2010
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