Healthcare Provider Details

I. General information

NPI: 1083233480
Provider Name (Legal Business Name): EMILE IRENE GLEESON MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/15/2020
Last Update Date: 07/24/2026
Certification Date: 07/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

98 JAMES ST STE 401
EDISON NJ
08820-3902
US

IV. Provider business mailing address

331 NEWMAN SPRINGS RD STE 220
RED BANK NJ
07701-5792
US

V. Phone/Fax

Practice location:
  • Phone: 848-308-5367
  • Fax: 848-308-5368
Mailing address:
  • Phone: 732-807-0877
  • Fax: 201-751-1680

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VC0300X
TaxonomyComplex Family Planning Physician
License Number25MA13193400
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: