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Individual

ALEXANDER B GLICKMAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
215 PASSAIC AVE, PASSAIC, NJ 07055-3604
(973) 779-7999
Mailing address
PO BOX 5220, TOMS RIVER, NJ 08754-5220
(732) 349-3838
(732) 349-2233

Taxonomy

Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
25MA06345200
NJ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
01000449006
AMERICHOICE
01
0699977
GHI
01
0993219000
AMERIHEALTH
01
1144690
MHP
01
1821709
UHC
01
2K7355
HEALTHNET
01
30148
UHP
01
3544558
AETNA
05
6945805
NJ
01
83783
AMGP
01
P00165380
RRM
01
P1281074
OX
Enumeration date
05/15/2006
Last updated
03/30/2016
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