Jacob Glickman
Student in an Organized Health Care Education/Training Program in New York, NY. Individual provider (NPI-1).
NPI number1164097432
StatusActive
Last updated in NPPESJun 7, 2021
Details
- NPI
- 1164097432
- Entity type
- Individual (NPI-1)
- Name
- Jacob Glickman
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- May 20, 2021
- Certification date
- Jun 7, 2021
- Last updated
- Jun 7, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 390200000X | Student in an Organized Health Care Education/Training Program | – | – | Yes |
Practice location
Department Of Dermatology, 5 E. 98th St.New York, NY 10029-1002
Phone 212-241-9768
Mailing address
45 W 67th St Apt 8fNew York, NY 10023-6260
Phone 201-452-8617
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