Jessica Lynn Glick, RPH

Primary specialty

Ambulatory Care PharmacistTaxonomy code 1835P2201X

License

041286 Issued in NY

Practice address

254 Hillside Ave
Williston Park, NY 11596-2201

Phone

(516) 739-2980

NPI assigned

Jan 8, 2024

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

Other names 1

• Mrs. Jessica Lynn Modlin Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Pharmacist

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.

• CVS Albany LLC

  • Pharmacy
  • Williston Park, NY
  • NPI 1013011873
  NPD (past)
• CVS Albany LLC

  • Pharmacy
  • Brooklyn, RI
  • NPI 1679459481
  NPD (past)

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

{
    "created_epoch": "1704672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704672000000",
    "number": "1992575351",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 WATERSEDGE CT",
            "city": "LOCUST VALLEY",
            "state": "NY",
            "postal_code": "115601126",
            "telephone_number": "516-724-0886"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "254 HILLSIDE AVE",
            "city": "WILLISTON PARK",
            "state": "NY",
            "postal_code": "115962201",
            "telephone_number": "516-739-2980"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLICK",
        "first_name": "JESSICA",
        "middle_name": "LYNN",
        "name_prefix": "Ms.",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-01-08",
        "last_updated": "2024-01-08",
        "certification_date": "2024-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1835P2201X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Ambulatory Care",
            "state": "NY",
            "license": "041286",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JESSICA",
            "last_name": "MODLIN",
            "middle_name": "LYNN",
            "prefix": "MRS.",
            "credential": "RPH",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Genesis Rehab Physical Therapy PC
• Carolyn M. Genna, AUD, FAAA
• Genovese Drug Stores Inc
• Sumi George
• Rena Ghelichkhani
• Justine Cancilla Golden, PSY.D.
• Howard Mark Goldstein, M.D.
• Emily Gomez, OTD, OTR/L
• Erik Gorelik
• Edward Justin Gottlieb, D.D.S.

• Ambulatory Care Pharmacist in Williston Park, NY
• Providers in Williston Park, NY by specialty
• Ambulatory Care Pharmacist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2024; 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.