# GLUTALITY PROVIDER GROUP OF NEW JERSEY, PA.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1396335675
- **Authorized official:** MITCHELL STOTTLAND (OWNER)
- **Authorized official phone:** (561) 678-2026

## Contact information

- **Practice address:** 3600 ROUTE 66 STE 150, NEPTUNE, NJ 07753-2645
- **Practice address phone:** (561) 678-2026
- **Mailing address:** 401 FAIRWAY DR STE 200, DEERFIELD BEACH, FL 33441-1800
- **Mailing address phone:** (561) 678-2026

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207R00000X | Internal Medicine Physician | — | NULL | Yes |
| 207R00000X | Internal Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 01/21/2021
- **Last updated:** 07/21/2025