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General NPI Number Information
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NPI Number | 1649320466
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Entity Type | Organization
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Legal Business Name | HARVEY W. GLICKER,DDS,PC
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Dates
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Enumeration Date | 01/12/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 700 HILLSIDE AVE
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City | NEW HYDE PARK
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State | NY
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Zip | 11040-2513
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Country | US
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Telephone | 516-775-7080
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Fax |
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Provider Business Mailing Address
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Address Line | 700 HILLSIDE AVE
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City | NEW HYDE PARK
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State | NY
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Zip | 11040-2513
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Country | US
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Telephone | 516-775-7080
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Fax |
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Authorized Official
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Title or Position | CHIEF EXCUTIVE OFFICER
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Name | DR. HARVEY GLICKER
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Credential | DDS
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Telephone | 516-775-7080
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0300X
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Taxonomy Name | Periodontics
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License Number | 028331-1
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License Number State | NY
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