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Individual

DANETTE GLENN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
445 HURFFVILLE CROSSKEYS RD BLDG A, SEWELL, NJ 08080-2337
(856) 218-2312
(856) 770-9194
Mailing address
445 HURFFVILLE CROSSKEYS RD BLDG A, SEWELL, NJ 08080-2337
(856) 309-7700
(856) 770-9194

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MA05317900
NJ
207R00000X
Internal Medicine Physician
MD041291
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
01243059
PA
05
0223191
NJ
Enumeration date
06/07/2006
Last updated
03/11/2024
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