Isaacson, Glenn C

Isaacson, Glenn C is an individual health care provider with primary practice located at 3509 N Broad St , Philadelphia PA 19140. He recently has only one registered license in Allopathic & Osteopathic Physicians / Otolaryngology, which is considered as his primary health care specialty. Isaacson, Glenn C can be contacted via phone (215) 707-7300.

Contact Information

Primary practice address
3509 N Broad St Philadelphia PA 19140
Phone: (215) 707-7300
Fax: (215) 707-6417
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Otolaryngology 207Y00000X MD030568E Pennsylvania

Profile Details

NPI number 1104814078
LBN Legal business name Isaacson, Glenn C
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 13th, 2005
Last updated May 21st, 2018 - about 7 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 1104814078 NPPES
Pennsylvania MEDICAID 0011396520001

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