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Individual

HYMAN GLICK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
133 BROOKLINE AVE, BOSTON, MA 02215-3904
(617) 654-7111
(617) 421-1065
Mailing address
133 BROOKLINE AVE, BOSTON, MA 02215-3904
(617) 654-7111
(617) 421-1065

Taxonomy

Speciality
Code
Description
License number
State
204C00000X
Sports Medicine (Neuromusculoskeletal Medicine) Physician
Primary
35054
MA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0014435
NHP
MA
05
2002078
MA
01
4414144-001
CIGNA
MA
01
705098
TUFTS
MA
01
B206
HPHC
MA
01
M08320
BCBS
MA
Enumeration date
12/26/2006
Last updated
03/04/2021
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