Mark Glicklich, MD

Primary specialty

Vascular & Interventional Radiology PhysicianTaxonomy code 2085R0204X

License

167925 Issued in NY

Practice address

3839 Danbury Rd
Brewster, NY 10509-5412

Phone

(845) 278-6200

Fax

(845) 278-7802

NPI assigned

Nov 28, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 7

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Northeast Radiology PC

  • Diagnostic Radiology Physician
  • Mount Kisco, NY
  • NPI 1255320727
  NPD (past)
• Northeast Radiology of Connecticut, LLC

  • Physiological Laboratory
  • Danbury, CT
  • NPI 1992180350
  NPD (past)

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

{
    "created_epoch": "1133136000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1497738199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3839 DANBURY RD",
            "city": "BREWSTER",
            "state": "NY",
            "postal_code": "105095412",
            "telephone_number": "845-278-6200",
            "fax_number": "845-278-7802"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3839 DANBURY RD",
            "city": "BREWSTER",
            "state": "NY",
            "postal_code": "105095412",
            "telephone_number": "845-278-6200",
            "fax_number": "845-278-7802"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLICKLICH",
        "first_name": "MARK",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-28",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085B0100X",
            "taxonomy_group": "",
            "desc": "Radiology, Body Imaging",
            "state": "NY",
            "license": "167925",
            "primary": false
        },
        {
            "code": "2085N0700X",
            "taxonomy_group": "",
            "desc": "Radiology, Neuroradiology",
            "state": "NY",
            "license": "167925",
            "primary": false
        },
        {
            "code": "2085N0904X",
            "taxonomy_group": "",
            "desc": "Radiology, Nuclear Radiology",
            "state": "NY",
            "license": "167925",
            "primary": false
        },
        {
            "code": "2085P0229X",
            "taxonomy_group": "",
            "desc": "Radiology, Pediatric Radiology",
            "state": "NY",
            "license": "167925",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NY",
            "license": "167925",
            "primary": false
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "NY",
            "license": "167925",
            "primary": true
        },
        {
            "code": "2085U0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Ultrasound",
            "state": "NY",
            "license": "167925",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elizabeth V. Getter, MD
• Jenna Rose Geyer, LCSW
• Linda Giampia-Hicks, RN
• Steven F Giovanniello, R.N.
• Jessica Gleason
• Lisa Goeddel, OTR
• Jonathan S Goldberg, MD
• Kathleen Holly Golzio
• Grace Bell Nutrition, CDN, PLLC
• Elissa Granata, APRN

• Vascular & Interventional Radiology Physician in Brewster, NY
• Providers in Brewster, NY by specialty
• Vascular & Interventional Radiology Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.