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Contact Information

GLENN G GABISAN, MD
776 SHREWSBURY AVE
SUITE 201
TINTON FALLS, NJ07724-3006
 Phone: 732-530-4949
 Fax: 732-530-3618
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Orthopaedic Surgery

207X00000X 02 Physician/General Surgery
 

Foot and Ankle Surgery

207XX0004X 02 Physician/General Surgery
Indicates primary specialty

NPI Profile & details for GLENN G GABISAN · (Male)

NPI Number 1346227428
Status Active
Credentials MD
Entity Individual
Enumeration date 12/29/2005
Last updated 12/04/2017 - About 9 years ago
Sole proprietor 1 No
Identifiers
  • NJ License # 25MA06996300
  • NJ License # MA069963
  • NJ Medicaid 0047635
  • NJ Medicaid 3222403
  • NJ Other 7679694 AETNA ID#
  • NJ Other J34051 HEALTHNET ID#
  • NJ Other P3362517 OXFORD ID#
  • NJ Other P00163993 RR MEDICARE
  • NJ Other CC3884 RR MEDICARE GRP#
Hospital affiliation(s)
  • MONMOUTH MEDICAL CENTER - (Acute Care)
    300 SECOND AVENUE
    LONG BRANCH, NJ 07740
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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