# MONMOUTH MEDICAL CENTER FACULTY PRACTICE PLAN, INC.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1023064441
- **Authorized official:** TANYA KENNEY (MMCFPP MANAGER)
- **Authorized official phone:** (732) 923-6281

## Contact information

- **Practice address:** 300 2ND AVE, LONG BRANCH, NJ 07740-6303
- **Practice address phone:** (732) 571-0025
- **Practice address fax:** (732) 571-0400
- **Mailing address:** PO BOX 8000, DEPT 601, BUFFALO, NY 14267-0002
- **Mailing address phone:** (866) 295-0041
- **Mailing address fax:** (708) 342-2517

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207R00000X | Internal Medicine Physician | — | NULL | Yes |
| 207R00000X | Internal Medicine Physician | — | — | Yes |
| 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