Provider Demographics
NPI:1982674511
Name:GLANTZMAN, ADAM MICHAEL (DC)
Entity Type:Individual
Prefix:DR
First Name:ADAM
Middle Name:MICHAEL
Last Name:GLANTZMAN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28 UNION AVE
Mailing Address - Street 2:SUITE 1
Mailing Address - City:MANASQUAN
Mailing Address - State:NJ
Mailing Address - Zip Code:08736-3630
Mailing Address - Country:US
Mailing Address - Phone:732-223-0677
Mailing Address - Fax:732-223-6077
Practice Address - Street 1:28 UNION AVE
Practice Address - Street 2:SUITE 1
Practice Address - City:MANASQUAN
Practice Address - State:NJ
Practice Address - Zip Code:08736-3630
Practice Address - Country:US
Practice Address - Phone:732-223-0677
Practice Address - Fax:732-223-6077
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-25
Last Update Date:2011-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00408500111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ687200Medicare PIN