Dragon, Glenn M

Dragon, Glenn M is an individual health care provider with primary practice located at 509 N Broad St , Woodbury NJ 08096-1617. He recently has only one registered license in Allopathic & Osteopathic Physicians / Anesthesiology, which is considered as his primary health care specialty. Dragon, Glenn M can be contacted via phone (856) 848-4464.

Contact Information

Primary practice address
509 N Broad St Woodbury NJ 08096-1617
Phone: (856) 848-4464
Fax: (856) 848-7023
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Anesthesiology 207L00000X 25MA05686000 New Jersey

Profile Details

NPI number 1275528366
LBN Legal business name Dragon, Glenn M
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 14th, 2005
Last updated Mar 7th, 2023 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1275528366 NPPES
New Jersey Other 25MA56860 MEDI CAL LICENSE
New Jersey Other D05550100 MEDI CAL LICENSE
New Jersey MEDICAID 6566405 MEDI CAL LICENSE

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