MEDICARE: DR. BRIAN S GLATT M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208200000X	Plastic Surgery Physician	25MA02946100	NJ

General Provider Information

NPI Number	:	1184691875
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BRIAN S GLATT M.D.

Provider Business Mailing Address
First Line	:	310 MADISON AVE
Second Line	:	SUITE 100
City	:	MORRISTOWN
State	:	NJ
Zip	:	07960-6967
Country	:	US
Telephone Number	:	973-889-9300
Fax Number	:	973-889-9400

Provider Business Practice Location Address
First Line	:	310 MADISON AVE
Second Line	:	SUITE 100
City	:	MORRISTOWN
State	:	NJ
Zip	:	07960-6967
Country	:	US
Telephone Number	:	973-889-9300
Fax Number	:	973-889-9400

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/02/2006
Last Update Date	:	03/03/2020

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