Blaise K. Glodowski, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

MCO3280 Issued in NJ

Practice address

360 E Broad St
Gibbstown, NJ 08027-1470

Phone

(856) 423-3899

Fax

(856) 423-5450

NPI assigned

Feb 2, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Specialty

Chiropractic

Education

Life Chiropractic College, 1986

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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

• Gibbstown Chiropractic Center, Inc.

  • Chiropractor
  • Gibbstown, NJ
  • NPI 1235327081
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1170374400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1191283200000",
    "number": "1306984034",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "61 LICCIARDELLO DR",
            "city": "WOOLWICH TOWNSHIP",
            "state": "NJ",
            "postal_code": "080851819",
            "telephone_number": "856-241-1585"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "360 E BROAD ST",
            "city": "GIBBSTOWN",
            "state": "NJ",
            "postal_code": "080271470",
            "telephone_number": "856-423-3899",
            "fax_number": "856-423-5450"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLODOWSKI",
        "first_name": "BLAISE",
        "middle_name": "K.",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-02",
        "last_updated": "2007-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NJ",
            "license": "MCO3280",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2096200",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michael Entrekin, NCC
• Raymond Filipponi, DPM
• Timothy Matthew Giacobbe, PHARM.D
• Gibbstown Chiropractic Center, Inc.
• Gibbstown Dentistry, Inc.
• Greenwich Township Boe
• Rebecca Lynn Justice
• Stephanie Marucci, APN
• Jennifer Mendez
• Patrick S Nam, RPH

• All providers in Gibbstown, NJ
• Chiropractor in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.