Healthcare Provider Details

I. General information

NPI: 1831727684
Provider Name (Legal Business Name): MATTHEW FRANKLIN GLIKSMAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/28/2020
Last Update Date: 07/16/2025
Certification Date: 07/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1211 HAMBURG TPKE STE 205
WAYNE NJ
07470-5056
US

IV. Provider business mailing address

660 WHITE PLAINS RD STE 400
TARRYTOWN NY
10591-5107
US

V. Phone/Fax

Practice location:
  • Phone: 973-633-0808
  • Fax: 973-633-8811
Mailing address:
  • Phone: 914-984-2546
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number25MA12560000
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: