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General NPI Number Information
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NPI Number | 1750395901
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Entity Type | Individual
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Provider Name | BARBARA GLUCKIN PSY.D.
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Gender | Female
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Dates
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Enumeration Date | 07/27/2006
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Last Update Date | 10/12/2021
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Provider Practice Location Address
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Address Line | 22 PARK PL STE B
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City | GREAT NECK
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State | NY
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Zip | 11021-5012
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Country | US
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Telephone | 917-715-1236
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Fax |
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Provider Business Mailing Address
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Address Line | 30 BARSTOW RD APT 3E
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City | GREAT NECK
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State | NY
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Zip | 11021-2221
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Country | US
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Telephone | 917-715-1236
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 13999
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License Number State | NY
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