Individual
DR. JAMES GLEN SANDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
3 WEBSTER AVE, JERSEY CITY, NJ 07307-1824
(201) 216-1505
(201) 216-8803
Mailing address
6 HUDSON CT, APARTMENT #3-B, BAYONNE, NJ 07002-2135
(201) 216-1505
(201) 216-8803
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
25MB07524000
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0039217
—
NJ
Enumeration date
07/06/2005
Last updated
01/04/2012
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