DR. PHILIP L GLICK (NPI# 1841207016) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1841207016 |
| Entity Type | Individual |
| Full Name | DR. PHILIP L GLICK |
| Credential | MD |
| Practice Address |
100 High St Dept of Surgery Buffalo NY 14203-1126 |
| Mailing Address |
Po Box 8000 Dept 313 University At Buffalo Surgeons, Inc. Buffalo NY 14267-0002 |
| Practice Telephone | 7168593371 |
| Practice Fax Number | 7168594580 |
| Mailing Telephone | 7168884889 |
| Mailing Fax Number | 7168495620 |
| Enumeration Date | 2006-08-01 |
| Last Update Date | 2014-03-26 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2086S0120X |
Surgery Specialization: Pediatric Surgery |
175202 | NY | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | 01084179 | 05 |
| Street Address |
100 HIGH ST DEPT OF SURGERY |
| City | BUFFALO |
| State | NY |
| Zip Code | 14203-1126 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093712077 | Kristen M Salvamoser | Physician Assistant | 100 High St, Buffalo, NY 14203-1126 | 2005-07-05 |
| 1801401765 | Sheena Deering | Nurse Practitioner | 100 High St, Buffalo, NY 14203-1126 | 2020-09-08 |
| 1528679321 | Sarah E Hinterberger | Nurse Practitioner | 100 High St, Buffalo, NY 14203-1126 | 2020-08-14 |
| 1841801537 | Amanda Scafetta | Nurse Practitioner | 100 High St, Buffalo, NY 14203-1126 | 2020-08-14 |
| 1023629938 | Ashlie Graham | Nurse Practitioner | 100 High St, Buffalo, NY 14203-1126 | 2020-08-13 |
| 1740800747 | Brian Girard | Student in an Organized Health Care Education/Training Program | 100 High St, Buffalo, NY 14203-1126 | 2020-04-20 |
| 1558981761 | Jule Deren | Student in an Organized Health Care Education/Training Program | 100 High St, Buffalo, NY 14203-1126 | 2020-04-17 |
| 1164041505 | Matthew Jon Peterson | Student in an Organized Health Care Education/Training Program | 100 High St, Buffalo, NY 14203-1126 | 2020-04-15 |
| 1679192249 | Garrett Skinner | Student in an Organized Health Care Education/Training Program | 100 High St, Buffalo, NY 14203-1126 | 2020-04-13 |
| 1245859065 | Kenan Rodwan Rajjoub | Student in an Organized Health Care Education/Training Program | 100 High St, Buffalo, NY 14203-1126 | 2020-04-12 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912514902 | Valerie Anne Conley | Counselor | 475 Elllicott St., Buffalo, NY 14203 | 2020-09-24 |
| 1457975674 | Qing Ma | Pharmacist | Nys Center of Excellence In Bioinformatics and Life Sci, 701 Ellicott Street, Buffalo, NY 14203 | 2020-06-03 |
| 1265056659 | Elizabeth Nicole Mancuso | Student in an Organized Health Care Education/Training Program | 1001 Main Street University At Buffalo, Department of P, 5th Floor, Buffalo, NY 14203 | 2020-06-02 |
| 1720601404 | Ronak Dhiraj Bahuva | Student in an Organized Health Care Education/Training Program | 955 Main Street, University At Buffalo, Jacobs School O, Buffalo, NY 14203 | 2020-05-28 |
| 1780207266 | Jaya Mishra | Student in an Organized Health Care Education/Training Program | 818 Ellicot Street, Buffalo, NY 14203 | 2020-05-19 |
| 1013530617 | Amanpreet Kaur Singh | Student in an Organized Health Care Education/Training Program | 77 Goodell Street Department of Medicine, Suite 240, Buffalo, NY 14203 | 2020-05-19 |
| 1013538917 | Leen Hosam Alyacoub | Student in an Organized Health Care Education/Training Program | 100 High Street, D2-76 Buffalo, Ny 14203, Buffalo Gener, Buffall, NY 14203 | 2020-05-01 |
| 1003436601 | Maxiam Dean | Student in an Organized Health Care Education/Training Program | Ub Family Residency Program, 77 Goodell Street, 2nd Floor, Buffalo, NY 14203 | 2020-04-23 |
| 1144849837 | Jennifer Anthone-kloss | Student in an Organized Health Care Education/Training Program | Anesthesiology Residency & Fellowship Programs, Ub Gateway, 77 Goodell Street, Suite 550, Buffalo, NY 14203 | 2020-04-13 |
| 1821658873 | Peter William Ip Fung Chun | Student in an Organized Health Care Education/Training Program | 1001 Main Street, Room 5145, Division of Pediatric Medical Education, Buffalo, NY 14203 | 2019-06-20 |
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| Taxonomy Code | 2086S0120X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| Specialization | Pediatric Surgery |
| A surgeon with expertise in the management of surgical conditions in premature and newborn infants, children and adolescents. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457500423 | Elizabeth Ann Bowdish | Surgery | 219 Bryant St, Women and Children's Hospital of Buffalo, Buffalo, NY 14222-2006 | 2008-09-15 |
| 1841406022 | Kathryn D. Bass | Surgery | 219 Bryant St., Dept. of Surgery, Buffalo, NY 14222-2006 | 2007-05-15 |
| 1538204748 | Kaveh Vali | Surgery | 219 Bryant St., Dept of Surgery, Buffalo, NY 14222-2006 | 2007-02-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972154243 | Andrea Volpe | Surgery | 504 E 63rd St Apt 17n, New York, NY 10065-7920 | 2019-09-26 |
| 1225388416 | Lucas Krauel | Surgery | 404 E 66th St Apt 1e, New York, NY 10065-9309 | 2012-09-14 |
| 1780983460 | Jun Tashiro | Surgery | 530 1st Ave Ste 10w, New York, NY 10016-6402 | 2011-03-21 |
| 1497914675 | Brian Arrinza Coakley | Surgery | 5 East 98th Street Box 1259, Department of Surgery Mount Sinai School of Medicine, New York, NY 10029 | 2008-06-03 |
| 1164691457 | Oliver Hans-josef Hans-josef Muensterer | Surgery | Mfch, Munger Pavillion, Room 321, Valhalla, NY 10595 | 2008-02-21 |
| 1942355698 | Stephen Dolgin | Surgery | Lij Dept of Surgery Pediatric Surgery, 269 01 76th Avenue, New Hyde Park, NY 11040 | 2007-01-24 |
| 1093875114 | Samuel Soffer | Surgery | Lijmc Dept of Surgery Peds Surgery, 270 05 76th Avenue, New Hyde Park, NY 11040 | 2006-12-11 |
| 1023182649 | Radhakrishman Satheesan | Surgery | 921 49th St, Brooklyn, NY 11219-2923 | 2006-11-17 |
| 1922178375 | Richard Glick | Surgery | Schneider Children Hospital, 269-01 76th Avenue, New Hyde Park, NY 11040 | 2006-11-09 |
| 1134201304 | Scott J Boley | Surgery | Div. of Pediatric Surgery, 3355 Bainbridge Avenue, Bronx, NY 10467 | 2006-10-19 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.