Healthcare Provider Details

I. General information

NPI: 1174844484
Provider Name (Legal Business Name): EMILY R. GLEIMER D.O
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: EMILY R. GOLDENTHAL DO

II. Dates (important events)

Enumeration Date: 06/21/2010
Last Update Date: 10/08/2025
Certification Date: 10/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 BOWMAN DR STE E315
VOORHEES NJ
08043
US

IV. Provider business mailing address

301 LIPPINCOTT DR STE 120
MARLTON NJ
08053-4197
US

V. Phone/Fax

Practice location:
  • Phone: 856-247-7310
  • Fax: 856-247-7309
Mailing address:
  • Phone: 856-355-0340
  • Fax: 856-355-0330

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VX0201X
TaxonomyGynecologic Oncology Physician
License Number25MB09439300
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: