Organization Active NPI

Jeffrey Glick MD PC

  • Internal Medicine Physician
  • New York, NY
National Provider Identifier
1003111857
Registry record updated Jan 25, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
179065-1 Issued in NY
Legal business name
JEFFREY GLICK MD PC
Practice address
117 E 65TH St
New York, NY 10065-7006
Phone
(212) 861-4278
NPI assigned
Jan 25, 2011
Last updated
Jan 25, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Jeffrey Gilck, MD
Title
Owner
Phone
(800) 750-8616

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 179065-1 NY Primary

Addresses

Primary practice location

117 E 65TH St
New York, NY 10065-7006

Mailing address

26 Firemens Memorial Dr
Suite 115
Pomona, NY 10970-3553
Phone (845) 362-8400

National Provider Directory

National Provider Directory

Locations

117 E 65th St
New York, NY 10065
Phone (212) 327-4691

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1295913600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1295913600000",
    "number": "1003111857",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26 FIREMENS MEMORIAL DR",
            "address_2": "SUITE 115",
            "city": "POMONA",
            "state": "NY",
            "postal_code": "109703553",
            "telephone_number": "845-362-8400",
            "fax_number": "845-362-8474"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "117 E 65TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100657006",
            "telephone_number": "212-861-4278"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEFFREY GLICK MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-01-25",
        "last_updated": "2011-01-25",
        "status": "A",
        "authorized_official_last_name": "GILCK",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "800-750-8616",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "179065-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.