Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Stephan R Glicken, MD

Individual provider Pediatrics Physician · NPI 1225144041

Stephan R Glicken, MD is a Pediatrics Physician in Hazleton, Pennsylvania. Works from 2 locations. Licensed in Massachusetts and Pennsylvania.

Licensed in
MA, PA
In the registry since
2006
Specialties on file
2
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

564 W Broad St
Hazleton, PA 18201-6108
Phone: (570) 501-6400
Fax: (570) 453-2353
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 420 South Jackson St, Pottsville, PA 17901 — (570) 621-5493

Specialties & licences

Pediatrics Physician (primary) Taxonomy 208000000X · Licence MD433646 (PA)
Pediatrics Physician Taxonomy 208000000X · Licence 75192 (MA)

Record details

NPI number1225144041
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedAugust 22, 2006
Last updated in NPPESFebruary 13, 2020
Certification dateFebruary 13, 2020

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