Organization
EATONTOWN PRIMARY CARE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MANAR H HANNA MD (MD)
(732) 542-4411
Entity
Organization
Contact information
Practice address
117 STATE ROUTE 35, EATONTOWN, NJ 07724-1885
(732) 542-4411
(732) 542-1070
Mailing address
117 STATE ROUTE 35, EATONTOWN, NJ 07724-1885
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
25MA07738500
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
099326
MEDICARE GROUP NUMBER
NJ
Enumeration date
09/19/2007
Last updated
01/25/2011
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