Individual
TARA E. GLEESON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
2201 CHAPEL AVE W, CHERRY HILL, NJ 08002-2048
(856) 488-6816
(856) 488-6511
Mailing address
307 S EVERGREEN AVE, WOODBURY, NJ 08096-2739
(856) 686-4300
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
MB61362
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6708404
—
NJ
Enumeration date
06/09/2006
Last updated
07/12/2007
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