Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | 25MA08653700 | NJ |
NPI | 1013174689 |
---|---|
Provider Name | Dr. Philip Justin Glassner |
First Address | Flemington, NJ 08822-4946 |
Second Address | Flemington, NJ 08822-4946 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/05/2008 |
Last Update Date | 15/12/2011 |