Individual
DANIEL G GLICKLICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
MMC - DEPT. OF MEDICINE, 111 EAST 210TH STREET, BRONX, NY 10467
(718) 920-5159
Mailing address
4465 DOUGLAS AVE, #5G, BRONX, NY 10471-3519
(718) 920-5159
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
139525
NY
Other
Enumeration date
10/27/2006
Last updated
07/08/2007
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