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
—
—
207RA0000X
Adolescent Medicine (Internal Medicine) Physician
—
—
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
—
—
207V00000X
Obstetrics & Gynecology Physician
—
—
207VM0101X
Maternal & Fetal Medicine Physician
—
—
207X00000X
Orthopaedic Surgery Physician
—
—
2085R0202X
Diagnostic Radiology Physician
—
—
208600000X
Surgery Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6441301
—
NJ
Enumeration date
05/26/2006
Last updated
03/09/2012
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