Provider Demographics
NPI:1184691875
Name:GLATT, BRIAN S (MD)
Entity type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:S
Last Name:GLATT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:310 MADISON AVE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:MORRISTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07960-6967
Mailing Address - Country:US
Mailing Address - Phone:973-889-9300
Mailing Address - Fax:973-889-9400
Practice Address - Street 1:310 MADISON AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:MORRISTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07960-6967
Practice Address - Country:US
Practice Address - Phone:973-889-9300
Practice Address - Fax:973-889-9400
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-02
Last Update Date:2020-03-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MA02946100208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ093532CEJMedicare ID - Type Unspecified
NJI37713Medicare UPIN