Individual
LEE M. GLICKMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2 CAPITAL WAY STE 385, PENNINGTON, NJ 08534-2521
(609) 303-4838
(609) 303-4835
Mailing address
2 CAPITAL WAY STE 385, PENNINGTON, NJ 08534-2521
(609) 303-4838
(609) 303-4835
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
25MA05784200
NJ
207RC0000X
Cardiovascular Disease Physician
MA057842
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0563230000
AMERIHEALTH
NJ
01
—
060067986
MEDICARE RAILRAOD
NJ
01
—
1346962
PENNSYLVANIA BLUE SHIELD
NJ
05
—
5137900
—
NJ
Enumeration date
03/02/2006
Last updated
04/27/2021
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