Individual
MS. CHERYL M GLICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RPA-C
Contact information
Practice address
942A ROUTE 146, CLIFTON PARK, NY 12065-3614
(518) 371-8000
(518) 371-5338
Mailing address
711 TROY SCHENECTADY RD STE 203, LATHAM, NY 12110-2461
(518) 782-3700
(517) 782-3799
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
009618
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000407398001
BSNENY
NY
05
—
02494791
—
NY
01
—
070508000030
FIDELIS
NY
01
—
400815
MVP HEALTHCARE
NY
Enumeration date
08/31/2006
Last updated
01/25/2018
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