Individual
LORI GLICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
7420 25TH AVE, EAST ELMHURST, NY 11370-1428
(718) 350-3171
Mailing address
7715 113TH ST, APT. 5C, FOREST HILLS, NY 11375-7123
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
06/12/2012
Last updated
06/12/2012
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