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Organization
MONMOUTH MEDICAL CENTER FACULTY PRACTICE PLAN, INC.
Active
Organization
MONMOUTH MEDICAL CENTER FACULTY PRACTICE PLAN, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TANYA KENNEY (MMCFPP MANAGER)
(732) 923-6281
Entity
Organization
Contact information
Practice address
300 2ND AVE, LONG BRANCH, NJ 07740-6303
(732) 571-0025
(732) 571-0400
Mailing address
PO BOX 8000, DEPT 601, BUFFALO, NY 14267-0002
(866) 295-0041
(708) 342-2517
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
NULL
207R00000X
Internal Medicine Physician
Primary
—
—
207RA0000X
Adolescent Medicine (Internal Medicine) Physician
—
NULL
207RA0000X
Adolescent Medicine (Internal Medicine) Physician
—
—
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
—
NULL
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
—
—
207V00000X
Obstetrics & Gynecology Physician
—
NULL
207V00000X
Obstetrics & Gynecology Physician
—
—
207VM0101X
Maternal & Fetal Medicine Physician
—
NULL
207VM0101X
Maternal & Fetal Medicine Physician
—
—
207X00000X
Orthopaedic Surgery Physician
—
NULL
207X00000X
Orthopaedic Surgery Physician
—
—
2085R0202X
Diagnostic Radiology Physician
—
NULL
2085R0202X
Diagnostic Radiology Physician
—
—
208600000X
Surgery Physician
—
NULL
208600000X
Surgery Physician
—
—
Other
Enumeration date
05/26/2006
Last updated
03/09/2012
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