Provider Demographics
NPI:1114077989
Name:GLICKER, HARVEY (DDS)
Entity Type:Individual
Prefix:DR
First Name:HARVEY
Middle Name:
Last Name:GLICKER
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:700 HILLSIDE AVE
Mailing Address - Street 2:
Mailing Address - City:NEW HYDE PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11040-2513
Mailing Address - Country:US
Mailing Address - Phone:516-775-7080
Mailing Address - Fax:516-775-1439
Practice Address - Street 1:700 HILLSIDE AVE
Practice Address - Street 2:
Practice Address - City:NEW HYDE PARK
Practice Address - State:NY
Practice Address - Zip Code:11040-2513
Practice Address - Country:US
Practice Address - Phone:516-775-7080
Practice Address - Fax:516-775-1439
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY028331-11223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics