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Individual

KRISTEN M GLICK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA

Contact information

Practice address
267 GRANT ST, BRIDGEPORT, CT 06610-2805
(203) 384-3693
(203) 384-3693
Mailing address
267 GRANT ST, BRIDGEPORT, CT 06610-2805
(203) 384-3693
(203) 384-3693

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
012938
NY
363A00000X
Physician Assistant
Primary
2772
CT

Other

Enumeration date
10/30/2008
Last updated
08/28/2014
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