Provider Demographics
NPI:1639303357
Name:GLIED, ALLEN NACHUM (DDS)
Entity Type:Individual
Prefix:DR
First Name:ALLEN
Middle Name:NACHUM
Last Name:GLIED
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 1:501 MADISON AVE FL 18
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10022-5613
Mailing Address - Country:US
Mailing Address - Phone:212-308-9200
Mailing Address - Fax:646-308-1160
Practice Address - Street 1:501 MADISON AVE FL 18
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10022-5613
Practice Address - Country:US
Practice Address - Phone:212-308-9200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-05-09
Last Update Date:2023-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY054323204E00000X
NY054323-11223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
No204E00000XAllopathic & Osteopathic PhysiciansOral & Maxillofacial Surgery