Provider Demographics
NPI:1568672533
Name:GLICK, ANA B (MD)
Entity Type:Individual
Prefix:DR
First Name:ANA
Middle Name:B
Last Name:GLICK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:235 GARTH RD
Mailing Address - Street 2:
Mailing Address - City:SCARSDALE
Mailing Address - State:NY
Mailing Address - Zip Code:10583-3917
Mailing Address - Country:US
Mailing Address - Phone:914-723-8173
Mailing Address - Fax:914-723-8173
Practice Address - Street 1:235 GARTH RD
Practice Address - Street 2:
Practice Address - City:SCARSDALE
Practice Address - State:NY
Practice Address - Zip Code:10583-3917
Practice Address - Country:US
Practice Address - Phone:914-723-8173
Practice Address - Fax:914-723-8173
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-22
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY09939302084P0015X
NY0939302084P0015X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0015XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychosomatic Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY342271Medicare UPIN