Atlas, Glen Mark

Atlas, Glen Mark is an individual health care provider with primary practice located at 150 Bergen St Level E, Newark NJ 07103-2496. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Anesthesiology, Allopathic & Osteopathic Physicians / Pain Medicine. Allopathic & Osteopathic Physicians / Anesthesiology is his primary health care specialty. Atlas, Glen Mark can be contacted via phone (973) 972-5787.

Contact Information

Primary practice address
150 Bergen St Level E Newark NJ 07103-2496
Phone: (973) 972-5787
Fax: (973) 972-4172
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Anesthesiology 207L00000X 25MA07119100 New Jersey
Allopathic & Osteopathic Physicians / Pain Medicine 207LP2900X 25MA07119100 New Jersey

Profile Details

NPI number 1295895894
LBN Legal business name Atlas, Glen Mark
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 12th, 2006
Last updated Oct 24th, 2022 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1295895894 NPPES
New Jersey MEDICAID 8377201

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