Organization Active NPI

Gary M Glickman, M.D. P. C.

  • Ophthalmology Physician
  • New York, NY
National Provider Identifier
1518035252
Registry record updated Nov 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
Legal business name
GARY M GLICKMAN, M.D. P. C.
Practice address
30 Park Ave
New York, NY 10016-3801
Phone
(212) 532-2500
Fax
(212) 532-9689
NPI assigned
Dec 1, 2006
Last updated
Nov 13, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2020

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

Authorized official

Name
Gary M Glickman MD PC
Title
President
Phone
(212) 532-2500

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X NU Primary

Addresses

Primary practice location

30 Park Ave
New York, NY 10016-3801

Mailing address

30 Park Ave
New York, NY 10016-3801
Phone (212) 532-2500

Other identifiers 3

IdentifierTypeStateIssuer
02046220MedicaidNY
165722OtherNYNY LICENSE
01005201MedicaidNY

Other names 1

  • Gary M. Glickman, MD PC Other name

National Provider Directory

National Provider Directory

Locations

30 Park Ave
New York, NY 10016
Phone (212) 420-6002

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1164931200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1605225600000",
    "number": "1518035252",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 PARK AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100163801",
            "telephone_number": "212-532-2500",
            "fax_number": "212-532-9689"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 PARK AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100163801",
            "telephone_number": "212-532-2500",
            "fax_number": "212-532-9689"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GARY M GLICKMAN, M.D. P. C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-01",
        "last_updated": "2020-11-13",
        "certification_date": "2020-11-13",
        "status": "A",
        "authorized_official_last_name": "GLICKMAN MD PC",
        "authorized_official_first_name": "GARY",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "212-532-2500"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02046220",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NY LICENSE",
            "identifier": "165722",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01005201",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Gary M. Glickman, MD PC",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Gary M. Glickman, MD PC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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 Nov 13, 2020; 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.