Doctor Name: | DR. BENJAMIN THOMAS GLIKO |
NPI Number: | 1629116900 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | PSY.D. |
License Number: | 4390 |
Business Practice Address: | 626 N Thompson St Raritan, NJ - 088691343 |
Business Phone Number: | 9087258877 |
Business Fax Number: | |
Mailing Address: | 726 County Road 513, PITTSTOWN |
State: | NJ |
Postal Code: | 088675163 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 02/01/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103G00000X |
License Number: | 4390 |
Healthcare Provider Taxonomy: (Secondary) | X |
State: | NJ |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Clinical Neuropsychologist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual with a doctorate degree, licensure in clinical psychology and specialized training or board certification in neuropsychology who practices or adheres to the principles of neuropsychology; a specialty within the field of psychology focusing primarily on neurobehavioral functioning. |