Glenn W. Laub, MD

Primary specialty

Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianTaxonomy code 208G00000X

License

MD070314L Issued in PA

Practice address

2 Stout Rd
Princeton, NJ 08540

Phone

(609) 712-7972

Fax

(609) 543-2453

NPI assigned

May 10, 2006

Last updated

Dec 2, 2019By 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

Other identifiers 13

Medicare fee-for-service enrollment

Enrolled in PA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Drexel University

  dba Drexel Psychology

  • Psychologist
  • Philadelphia, PA
  • NPI 1902900095
  Medicare reassignment NPD
• Drexel University

  dba Pennsylvania Ear Institute

  • Audiologist
  • Elkins Park, PA
  • NPI 1104822253
  NPD
• Drexel University

  dba Drexel Rheumatology

  • Rheumatology Physician
  • Philadelphia, PA
  • NPI 1437253762
  NPD
• St. Francis Medical Center

  • General Acute Care Hospital
  • Trenton, NJ
  • NPI 1255419651
  NPD (past)
• Drexel University

  dba Drexel CT Surgery

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Philadelphia, PA
  • NPI 1154425254
  NPD (past)
• Philadelphia Health & Education Corporation

  dba Drexel Gynecology-Oncology Services

  • Gynecologic Oncology Physician
  • Philadelphia, PA
  • NPI 1356496038
  NPD (past)

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

{
    "created_epoch": "1147219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1575244800000",
    "number": "1417906066",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 STOUT RD",
            "city": "PRINCETON",
            "state": "NJ",
            "postal_code": "085407441",
            "telephone_number": "609-712-7972",
            "fax_number": "609-543-2453"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 STOUT RD",
            "city": "PRINCETON",
            "state": "NJ",
            "postal_code": "08540",
            "telephone_number": "609-712-7972",
            "fax_number": "609-543-2453"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "230 N Broad St",
            "address_2": "744 North Tower",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191021121",
            "country_code": "US",
            "telephone_number": "215-762-7802",
            "fax_number": "215-762-1858",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "230 N Broad St",
            "address_2": "744 North Tower",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191021121",
            "country_code": "US",
            "telephone_number": "215-762-7802",
            "fax_number": "215-762-1858",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LAUB",
        "first_name": "GLENN",
        "middle_name": "W.",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-10",
        "last_updated": "2019-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "NJ",
            "license": "25MA05182700",
            "primary": false
        },
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "PA",
            "license": "MD070314L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERICHOICE",
            "identifier": "1000338800",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIHEALTH",
            "identifier": "418181000",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HORIZON NJ HEALTH",
            "identifier": "1130387",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHNET/PHS",
            "identifier": "1K6468",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "780001881",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD",
            "identifier": "P390840",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0584908",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "2026938",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNIVERSITY HEALTH PLAN",
            "identifier": "29208",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDEPENDENT BCBS",
            "identifier": "595777PDM",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIGROUP",
            "identifier": "83490",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "2337125",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KEYSTONE HEALTHPLAN",
            "identifier": "418181000",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Melissa M Lantz, DO
• Brittany Lapar, CRNP
• Bartley A Larsen, M.D.
• Karen M. Latzko, D.O.
• Dana Marie Lau, PSY.D.
• Laura Shwahla
• Laurie Mulvey, MD L.L.C
• Raymond Lavender, LSW
• Helen K Law, LAC
• Jennifer T. Law, LAC

• Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician in Princeton, NJ
• Providers in Princeton, NJ by specialty
• Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.