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Individual

DR. PETER LOUIS GLICKMAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
61 E 77TH ST, NEW YORK, NY 10075-1817
(212) 772-3111
Mailing address
450 E 20TH ST, APT 8H, NEW YORK, NY 10009-8238
(646) 244-7856

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
MD426075
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
03241196
NY
05
054764600
FL
01
101234464
AMERICHOICE OF PA
PA
05
101234464
PA
05
1600156
LA
05
1659350734
IA
01
1725277
HIGHMARK BLUE SHIELD
PA
05
200262380A
OK
01
231955165
INTERGROUP SERVICES
PA
01
2393615000
KHPE
PA
05
2855227
OH
01
30020753
KEYSTONE MERCY
PA
05
808352700
ID
01
9336768
PHCS
PA
05
MD001PA
AK
01
MD426075
HEALTH PARTNERS
PA
01
P00229796
RAILROAD MEDICARE
PA
01
PA7584
HEALTHNET
PA
Enumeration date
01/17/2006
Last updated
08/05/2015
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