Organization
GLENDORA FAMILY PRACTICE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BENJAMIN IRA BLANK DO (PRESIDENT)
(856) 939-2828
Entity
Organization
Contact information
Practice address
1300 BLACK HORSE PIKE, GLENDORA, NJ 08029-1308
(856) 939-2828
(856) 939-5057
Mailing address
1300 BLACK HORSE PIKE, GLENDORA, NJ 08029-1308
(856) 939-2828
(856) 939-5057
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
25MB06092600
NJ
Other
Enumeration date
05/23/2006
Last updated
01/02/2009
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