Healthcare Provider Details

I. General information

NPI: 1487689162
Provider Name (Legal Business Name): BARRY GLASSER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/11/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4248 HARBOUR BEACH BLVD
BRIGANTINE NJ
08203-1361
US

IV. Provider business mailing address

4206 KAREN CT
MAYS LANDING NJ
08330-3017
US

V. Phone/Fax

Practice location:
  • Phone: 609-266-0400
  • Fax: 609-948-3047
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMA44569
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: