Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208000000X | Pediatrician | 232623 | NY |
NPI | 1003961947 |
---|---|
Provider Name | Dr. Gayle Glik |
First Address | Scarsdale, NY 10583-5914 |
Second Address | Scarsdale, NY 10583-5059 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/01/2007 |
Last Update Date | 08/07/2007 |