Provider Demographics
NPI:1063729127
Name:FRANCES GLICKSMAN MD PA
Entity type:Organization
Organization Name:FRANCES GLICKSMAN MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:FRANCES
Authorized Official - Middle Name:
Authorized Official - Last Name:GLICKSMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-674-1887
Mailing Address - Street 1:5 CHIPPEWA CT
Mailing Address - Street 2:
Mailing Address - City:SUFFERN
Mailing Address - State:NY
Mailing Address - Zip Code:10901-4158
Mailing Address - Country:US
Mailing Address - Phone:305-790-7049
Mailing Address - Fax:
Practice Address - Street 1:4302 ALTON RD STE 105
Practice Address - Street 2:
Practice Address - City:MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33140-2892
Practice Address - Country:US
Practice Address - Phone:305-674-1887
Practice Address - Fax:305-674-1890
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-09
Last Update Date:2023-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0051210261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL057769300Medicaid
FL057769300Medicaid
FLE59222Medicare UPIN