Amy Borg Glickman, MD

Primary specialty

Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X

License

63790 Issued in NJ

Practice address

655 E Jersey St
1St Floor Therapeutic Nursery
Elizabeth, NJ 07206

Phone

(908) 994-7033

NPI assigned

Dec 5, 2006

Sex

Female

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 Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: aborg-glickman@mhaessexmorris.medalliesdirect.net

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.

• Mental Health Association of Essex and Morris, Inc.

  • Mental Health Counselor
  • Montclair, NJ
  • NPI 1790721108
  NPD

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

{
    "created_epoch": "1165276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1710045323",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "655 E JERSEY ST",
            "address_2": "1ST FLOOR THERAPEUTIC NURSERY",
            "city": "ELIZABETH",
            "state": "NJ",
            "postal_code": "07206",
            "telephone_number": "908-994-7033"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "655 E JERSEY ST",
            "address_2": "1ST FLOOR THERAPEUTIC NURSERY",
            "city": "ELIZABETH",
            "state": "NJ",
            "postal_code": "07206",
            "telephone_number": "908-994-7033"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BORG GLICKMAN",
        "first_name": "AMY",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "NJ",
            "license": "63790",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bolanowski Surgical Group PC
• Steven Bolten, L.S.W, L.C.A.D.C.
• Laura Lynn Bond, PA-C
• Lisa Michelle Bond
• Sareli Bonilla
• Boro Healthcare of Union, P.C.
• Subutay Berke Bozkurt, MD
• Bracha Inc
• Glenn Robert Bradley, D.C
• Shaniqua J Bradley, LCSW

• Child & Adolescent Psychiatry Physician in Elizabeth, NJ
• Providers in Elizabeth, NJ by specialty
• Child & Adolescent Psychiatry Physician in New Jersey

• 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.