Individual
MR. BRIAN H GLICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1205 TROY SCHENECTADY RD STE 101, LATHAM, NY 12110-1074
(518) 348-3176
Mailing address
96 HUBBS RD, BALLSTON LAKE, NY 12019-2203
(518) 406-5374
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
005627-1
NY
Other
Enumeration date
03/07/2007
Last updated
10/19/2022
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