Individual
JAY GLICKMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
3790 MORRELL AVE, SUITE B, PHILADELPHIA, PA 19114-1955
(215) 612-1450
(215) 612-1420
Mailing address
3790 MORRELL AVE, SUITE B, PHILADELPHIA, PA 19114-1955
(215) 612-1450
(215) 612-1420
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
OS 009194-L
PA
Other
Enumeration date
06/24/2006
Last updated
07/08/2007
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