Glickman, Ethan Michael
Glickman, Ethan Michael is an individual health care provider with primary practice located at 515 Raritan Avenue , Highland Park NJ 08904-2901. He recently has only one registered license in Dental Providers / General Practice, which is considered as his primary health care specialty. Glickman, Ethan Michael can be contacted via phone (732) 572-4244.Contact Information
Primary practice address
515 Raritan Avenue
Highland Park NJ 08904-2901
Phone: (732) 572-4244
Fax: (732) 572-4274
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / General Practice | 1223G0001X | D1009925 | New Jersey |
Profile Details
| NPI number | 1508057142 |
|---|---|
| LBN Legal business name | Glickman, Ethan Michael |
| Credentials | Doctor of Dental Surgery (DDS) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 8th, 2007 |
| Last updated | Aug 8th, 2007 - about 17 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1508057142 | NPPES |
| New Jersey | MEDICAID | 0811408 |
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