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Individual

DR. GLENN KOLANSKY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
4 HARTFORD DR, SUITE 3, TINTON FALLS, NJ 07701-4929
(732) 933-8500
(732) 933-4177
Mailing address
4 HARTFORD DR, SUITE 3, TINTON FALLS, NJ 07701-4929
(732) 933-8500
(732) 933-4177

Taxonomy

Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
25MA06217900
NJ
207ND0101X
MOHS-Micrographic Surgery Physician
25MA06217900
NJ

Other

Enumeration date
11/13/2006
Last updated
06/28/2010
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