Provider Demographics
NPI:1609166412
Name:GLAZER, HILARY PAULEN (MD)
Entity Type:Individual
Prefix:
First Name:HILARY
Middle Name:PAULEN
Last Name:GLAZER
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 1:13764 DANCY AVE.
Mailing Address - Street 2:
Mailing Address - City:CLEWISTON
Mailing Address - State:FL
Mailing Address - Zip Code:33440-4061
Mailing Address - Country:US
Mailing Address - Phone:845-216-9709
Mailing Address - Fax:845-207-0033
Practice Address - Street 1:1500 WESTON RD
Practice Address - Street 2:SUITE 223
Practice Address - City:WESTON
Practice Address - State:FL
Practice Address - Zip Code:33326-3332
Practice Address - Country:US
Practice Address - Phone:954-707-1452
Practice Address - Fax:845-207-0033
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-13
Last Update Date:2022-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME1280372084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL017486900Medicaid