Provider Demographics
NPI:1033509674
Name:GLICKMAN, JONATHAN HARRY LIGHTER (PSYD)
Entity type:Individual
Prefix:DR
First Name:JONATHAN
Middle Name:HARRY LIGHTER
Last Name:GLICKMAN
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:710 STATION WAY
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON STATION
Mailing Address - State:NY
Mailing Address - Zip Code:11746-1937
Mailing Address - Country:US
Mailing Address - Phone:516-567-5036
Mailing Address - Fax:
Practice Address - Street 1:901 WASHINGTON AVE APT 6S
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11225-1041
Practice Address - Country:US
Practice Address - Phone:516-567-5036
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-02-04
Last Update Date:2025-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY024891103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist