Glenn David Lederman, D.C.

Primary specialty

Sports Physician ChiropractorTaxonomy code 111NS0005X

License

MC04697 Issued in NJ

Practice address

18 Tutor PL
East Brunswick, NJ 08816-3658

Phone

(732) 570-5675

NPI assigned

Nov 29, 2006

Last updated

Nov 3, 2016By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Kayal Medical Group, LLC

  dba Kayal Orthopaedic Center

  • Orthopaedic Surgery Physician
  • Franklin Lakes, NJ
  • NPI 1528729159
  Medicare reassignment
• Active Choices Chiropractic and Wellness LLC

  • Sports Physician Chiropractor
  • East Brunswick, NJ
  • NPI 1215167481
  NPD (past) Authorized official
• Adswellness LLC

  • Sports Physician Chiropractor
  • East Brunswick, NJ
  • NPI 1235341736
  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1164758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1478131200000",
    "number": "1285701888",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6262",
            "city": "EAST BRUNSWICK",
            "state": "NJ",
            "postal_code": "088166262"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18 TUTOR PL",
            "city": "EAST BRUNSWICK",
            "state": "NJ",
            "postal_code": "088163658",
            "telephone_number": "732-570-5675"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEDERMAN",
        "first_name": "GLENN",
        "middle_name": "DAVID",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-29",
        "last_updated": "2016-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH7049",
            "primary": false
        },
        {
            "code": "111NS0005X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Sports Physician",
            "state": "NJ",
            "license": "MC04697",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elizabeth W Lazzara, MD
• LBS Nutrition LLC
• Katherine Leahy, PSYD
• Michelle Lease, MD
• Yaron Lebovitz, MD
• Anna F Lee, MD
• Brian Lee
• Ellen Lee, MD
• Junho Lee
• Peter Y. Lee, MD

• Sports Physician Chiropractor in East Brunswick, NJ
• Providers in East Brunswick, NJ by specialty
• Sports Physician Chiropractor in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.