Individual
WILLIAM B GLENN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
1301 RT.72 WEST, SUITE 240, MANAHAWKIN, NJ 08050-3130
(609) 597-7394
(609) 597-6833
Mailing address
331 NEWMAN SPRINGS RD STE 220, RED BANK, NJ 07701-5792
(732) 807-0877
(201) 751-1680
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
25MB05217600
NJ
207Q00000X
Family Medicine Physician
Primary
MB52176
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2110601
—
NJ
01
—
223106655
TAX ID
NJ
Enumeration date
10/19/2006
Last updated
08/05/2024
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