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Individual

GARY M GLICKMAN M.D.

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
30 PARK AVE, NEW YORK, NY 10016-3801
(212) 532-2500
(212) 532-9689
Mailing address
30 PARK AVE, NEW YORK, NY 10016-3801
(212) 532-2500
(212) 532-9689

Taxonomy

Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
165722
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
01005201
NY
05
02046220
NY
01
165722
NY LICENSE
NY
Enumeration date
03/28/2006
Last updated
09/19/2014
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