Individual
DR. JON GLASS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
909 WALNUT ST, 2ND FLOOR, PHILADELPHIA, PA 19107-5211
(215) 955-7000
(215) 503-7007
Mailing address
909 WALNUT ST, 2ND FLORR, PHILADELPHIA, PA 19107-5211
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
MD046156
PA
2084N0400X
Neurology Physician
Primary
MD046156L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0012774220007
—
PA
05
—
5140501
—
NJ
Enumeration date
03/07/2006
Last updated
06/19/2019
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