Provider Demographics
NPI:1902913148
Name:GLICK, JULIE (AUD, F-AAA)
Entity Type:Individual
Prefix:DR
First Name:JULIE
Middle Name:
Last Name:GLICK
Suffix:
Gender:F
Credentials:AUD, F-AAA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:304 PARK AVE S
Mailing Address - Street 2:SUITE 1156
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10010-4301
Mailing Address - Country:US
Mailing Address - Phone:917-929-0268
Mailing Address - Fax:
Practice Address - Street 1:304 PARK AVE S
Practice Address - Street 2:SUITE 1156
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10010-4301
Practice Address - Country:US
Practice Address - Phone:917-929-0268
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-24
Last Update Date:2013-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY002125237600000X
NY14000023874237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter