Stephan R Glicken
MD | Pediatrics | Male
Stephan R Glicken, MD is a Hazleton, Pennsylvania based Pediatric doctor with medical specialization in
General Pediatrics.
Current practice location of Stephan R Glicken is
564 W Broad St, Hazleton, Pennsylvania - 18201-6108. He can be contacted on phone at
570-501-6400 and fax number 570-453-2353.
Stephan R Glicken is a sole proprietor of his business.
NPI number (Unique professional ID) for Stephan R Glicken is
1225144041 which was assigned by NPPES on 22 Aug, 2006 and it was last updated on 13 Feb, 2020.
Stephan R Glicken license number is
MD433646 for Pediatrics (208000000X) in Pennsylvania.
Stephan R Glicken is a pediatrician who is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.
Complete Profile:
Stephan R Glicken basic information including his official name, gender, specialization, credentials etc. are as mentioned below.
| Specialization : | Pediatrics |
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| Provider Name : | Stephan R Glicken |
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| Credential : | MD |
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| Gender : | Male |
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Business Address:
Stephan R Glicken address, contact phone number and fax are as below. Patients can directly walkin to the clinic or can call on the below given phone number for appointment.
| Primary Address : | 564 W Broad St
Hazleton, PA, 18201-6108
United States |
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| Phone Number : | 570-501-6400 |
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| Fax Number : | 570-453-2353 |
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Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). NPI details are as mentioned below.
| NPI Number : | 1225144041 |
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| NPI Entity Type : | Individual |
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| First Enrolment Date : | 22 Aug, 2006 |
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| Last Updated On : | 13 Feb, 2020 |
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Licenses and Specialities:
Physicians/Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Stephan R Glicken are as mentioned. Primary taxonomy code for Stephan R Glicken, MD is
208000000X (Pediatrics).
| Taxonomy Code | Speciality | Primary | License No. | State |
|---|
| 208000000X | Pediatrics | No | 75192 | MA |
| 208000000X | Pediatrics | Yes | MD433646 | PA |
Legacy Identifiers:
Other legacy medical identifiers of Stephan R Glicken such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned below.
| Identifier | Identifier Type | State | Issuer |
|---|
| 1021155010001 | MEDICAID | PA | |
| 102115501-0005 | MEDICAID | PA | |
| 3810012098 | MEDICAID | WV | |
| 2860426 | MEDICAID | OH | |
Other Practice Locations:
| Practice Address | City, State | Phone Number |
|---|
420 SOUTH JACKSON ST, PEDIATRIC FLOOR
POTTSVILLE, PA, 17901
United States | POTTSVILLE, PA | 570-621-5493 |
Mailing Address:
Mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned business address only.
| Mailing Address : | Po Box 783311
Philadelphia, PA, 19178-3311
United States |
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| Phone Number : | 484-884-4500 |
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| Fax Number : | 484-884-0699 |
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Business Location:
Patients can refer following map for directions to
Stephan R Glicken practice address. Don't forget to take prior appointment before visiting.
** Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES.