Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 213E00000X | Podiatrist | 25MD00332400 | NJ |
N | 222Z00000X | Podiatrist | 25MD00332400 | NJ |
N | 213E00000X | Podiatrist | SC006104 | PA |
N | 222Z00000X | Podiatrist | SC006104 | PA |
N | 213EP1101X | Primary Podiatric Medicine | SC006104 | PA |
N | 111NR0200X | Radiology | SC006104 | PA |
N | 213ER0200X | Radiology | SC006104 | PA |
N | 2081S0010X | Sports Medicine | SC006104 | PA |
N | 213ES0000X | Sports Medicine | SC006104 | PA |
Y | 213ES0103X | Foot & Ankle Surgery | SC006104 | PA |
N | 213ES0131X | Foot Surgery | SC006104 | PA |
NPI | 1558590299 |
---|---|
Provider Name | Dr. Glenn Michael Aufseeser |
First Address | Lakewood, NJ 08701-1253 |
Second Address | Lakewood, NJ 08701-1253 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/07/2009 |
Last Update Date | 16/06/2018 |