Provider Demographics
NPI:1316587801
Name:GLISERMAN, MARTIN JOEL (PHD, NCPSYA)
Entity type:Individual
Prefix:PROF
First Name:MARTIN
Middle Name:JOEL
Last Name:GLISERMAN
Suffix:
Gender:M
Credentials:PHD, NCPSYA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 LAWRENCE AVE
Mailing Address - Street 2:
Mailing Address - City:HIGHLAND PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:08904-1849
Mailing Address - Country:US
Mailing Address - Phone:908-227-3156
Mailing Address - Fax:
Practice Address - Street 1:120 LAWRENCE AVE
Practice Address - Street 2:
Practice Address - City:HIGHLAND PARK
Practice Address - State:NJ
Practice Address - Zip Code:08904-1849
Practice Address - Country:US
Practice Address - Phone:908-227-3156
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-13
Last Update Date:2020-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes102L00000XBehavioral Health & Social Service ProvidersPsychoanalyst