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Individual

GLENN JAY MALAT

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
O.D.

Contact information

Practice address
775 BLOOMFIELD AVE, WEST CALDWELL, NJ 07006-6701
(973) 226-3031
(973) 226-3033
Mailing address
18 RUBINO RD, WEST CALDWELL, NJ 07006-8000
(973) 276-9693
(973) 226-3033

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
270A00530101
NJ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2263858
UNITED HEALTHCARE
NJ
01
2K4029
HEALTH NET
NJ
01
480551
AETNA
NJ
01
P2664631
OXFORD
NJ
Enumeration date
09/27/2005
Last updated
07/08/2007
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