Provider Demographics
NPI:1245268895
Name:GLIJANSKY, ALEX (MD)
Entity type:Individual
Prefix:DR
First Name:ALEX
Middle Name:
Last Name:GLIJANSKY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1579 OLD YORK RD
Mailing Address - Street 2:
Mailing Address - City:ABINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:19001-1807
Mailing Address - Country:US
Mailing Address - Phone:215-830-1262
Mailing Address - Fax:215-830-1263
Practice Address - Street 1:1579 OLD YORK RD
Practice Address - Street 2:
Practice Address - City:ABINGTON
Practice Address - State:PA
Practice Address - Zip Code:19001-1807
Practice Address - Country:US
Practice Address - Phone:215-830-1262
Practice Address - Fax:215-830-1263
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-30
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD036998L2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA68504Medicare PIN
PAB34830Medicare UPIN