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General NPI Number Information
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NPI Number | 1619677416
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Entity Type | Organization
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Legal Business Name | KIM L GLICKMAN, LLC
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Dates
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Enumeration Date | 03/09/2023
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Last Update Date | 03/09/2023
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Provider Practice Location Address
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Address Line | 7 PONDFIELD RD STE 205
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City | BRONXVILLE
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State | NY
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Zip | 10708-3781
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Country | US
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Telephone | 718-795-3989
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Fax |
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Provider Business Mailing Address
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Address Line | 29 E BIRCH ST
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City | MOUNT VERNON
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State | NY
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Zip | 10552-1801
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Country | US
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Telephone | 718-795-3989
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | KIM GLICKMAN
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Credential | LCSW, PHD
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Telephone | 718-795-3989
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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