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Individual
DR. GLENN G GABISAN
Active
Individual
DR. GLENN G GABISAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
MA069963
NJ
207XX0004X
Orthopaedic Foot and Ankle Surgery Physician
25MA06996300
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0047635
—
NJ
05
—
3222403
—
NJ
01
—
7679694
AETNA ID#
NJ
01
—
CC3884
RR MEDICARE GRP#
NJ
01
—
J34051
HEALTHNET ID#
NJ
01
—
P00163993
RR MEDICARE
NJ
01
—
P3362517
OXFORD ID#
NJ
Enumeration date
12/29/2005
Last updated
12/04/2017
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