Individual
MR. GLEN MARTIN EWING
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
GRNA
Contact information
Practice address
150 BERGEN ST, RM#E-245, NEWARK, NJ 07103-2496
(973) 972-7867
(973) 972-2357
Mailing address
1701 S CENTRAL AVE, SOUTH PLAINFIELD, NJ 07080-3601
(908) 963-6192
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
26NO11090200
NJ
Other
Enumeration date
01/15/2009
Last updated
01/15/2009
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