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Individual

MARK GLICKLICH

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
3839 DANBURY RD, BREWSTER, NY 10509-5412
(845) 278-6200
(845) 278-7802
Mailing address
3839 DANBURY RD, BREWSTER, NY 10509-5412
(845) 278-6200
(845) 278-7802

Taxonomy

Speciality
Code
Description
License number
State
2085B0100X
Body Imaging Physician
167925
NY
2085N0700X
Neuroradiology Physician
167925
NY
2085N0904X
Nuclear Radiology Physician
167925
NY
2085P0229X
Pediatric Radiology Physician
167925
NY
2085R0202X
Diagnostic Radiology Physician
167925
NY
2085R0204X
Vascular & Interventional Radiology Physician
Primary
167925
NY
2085U0001X
Diagnostic Ultrasound Physician
167925
NY

Other

Enumeration date
11/28/2005
Last updated
09/11/2025
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