Individual
JACK E. EBANI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1820 CORLIES AVENUE, NEPTUNE, NJ 07753
(732) 774-4551
(732) 774-8933
Mailing address
1820 CORLIES AVENUE, NEPTUNE, NJ 07753
(732) 774-4551
(732) 774-8933
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
25MA04538800
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5043603
—
NJ
Enumeration date
12/13/2006
Last updated
03/17/2008
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