Provider Demographics
NPI:1912137357
Name:ALEXANDER B. GLICKMAN, M.D., P.A.
Entity Type:Organization
Organization Name:ALEXANDER B. GLICKMAN, M.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ALEXANDER
Authorized Official - Middle Name:B
Authorized Official - Last Name:GLICKMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:973-779-7999
Mailing Address - Street 1:PO BOX 5220
Mailing Address - Street 2:
Mailing Address - City:TOMS RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:08754-5220
Mailing Address - Country:US
Mailing Address - Phone:732-349-3838
Mailing Address - Fax:732-349-4816
Practice Address - Street 1:1081 PAULISON AVE
Practice Address - Street 2:
Practice Address - City:CLIFTON
Practice Address - State:NJ
Practice Address - Zip Code:07011-3658
Practice Address - Country:US
Practice Address - Phone:973-779-7999
Practice Address - Fax:973-779-7939
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-20
Last Update Date:2009-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Single Specialty