Jay Glickman, D.O.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

OS 009194-L Issued in PA

Practice address

3790 Morrell Ave
Suite B
Philadelphia, PA 19114-1955

Phone

(215) 612-1450

Fax

(215) 612-1420

NPI assigned

Jun 24, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Indepedence Medical Associates P.C.

  • Family Medicine Physician
  • Philadelphia, PA
  • NPI 1053348953
  Authorized official Same address or phone
• Liberty Medical Group PC

  • Family Medicine Physician
  • Philadelphia, PA
  • NPI 1972792257
  NPD (past)

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

{
    "created_epoch": "1151107200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1497781181",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3790 MORRELL AVE",
            "address_2": "SUITE B",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191141955",
            "telephone_number": "215-612-1450",
            "fax_number": "215-612-1420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3790 MORRELL AVE",
            "address_2": "SUITE B",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191141955",
            "telephone_number": "215-612-1450",
            "fax_number": "215-612-1420"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLICKMAN",
        "first_name": "JAY",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-24",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "OS 009194-L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Seth Nathaniel Glick, MD
• Alexandra Glickman, PA-C
• Danny Glickman, MD
• David M. Glickman, LPC
• Jacob Drault Glickman, PSYD, MA, LPC
• Joel D Glickman, MD
• Orli Marissa Glickman, DO
• Marc F. Glickstein, M.D.
• Jeffrey Glidden
• Jann Glider, PH.D.

• Family Medicine Physician in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Family Medicine Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.