Glendora Family Practice LLC

NPI #1750336392 in Glendora, New Jersey

Provider Information

NPI Number: 1750336392
Entity Type: Organization
Organization Name: Glendora Family Practice LLC
Primary Specialty: Family Medicine
Enumeration Date: May 23, 2006
Last Updated: Jan 2, 2009

Practice Location

Address: 1300 BLACK HORSE PIKE
City: Glendora
State: New Jersey
ZIP Code: 08029-1308
Phone: (856) 939-2828

Authorized Official

Name: DR. BENJAMIN IRA BLANK, DO
Title: PRESIDENT
Phone: (856) 939-2828

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Family Medicine	207Q00000X	Primary

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