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NPI 1053133876

NPI 1053133876 : ALLISON GLICKMAN OTD, OTR/L : DOUGLASTON, NY

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General NPI Number Information
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    NPI Number           |    1053133876
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    Entity Type          |    Individual 
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    Provider Name        |    ALLISON GLICKMAN OTD, OTR/L
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    10/31/2024
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    Last Update Date     |    04/08/2025
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Provider Practice Location Address
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    Address Line         |    24035 69TH AVE 
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    City                 |    DOUGLASTON
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    State                |    NY
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    Zip                  |    11362-1738
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    Country              |    US
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    Telephone            |    917-435-4804
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    24035 69TH AVE 
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    City                 |    DOUGLASTON
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    State                |    NY
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    Zip                  |    11362-1738
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    Country              |    US
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    Telephone            |    917-435-4804
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    Fax                  |    
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    225X00000X
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    Taxonomy Name        |    Occupational Therapist
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    License Number       |    OT4795
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    License Number State |    ME
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Taxonomy #2
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    Taxonomy Code        |    225X00000X
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    Taxonomy Name        |    Occupational Therapist
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    License Number       |    029660
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    License Number State |    NY
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