MEDICARE: FAMILY FIRST PRIMARY PHYSICIANS LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician

General Provider Information

NPI Number	:	1639847338
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FAMILY FIRST PRIMARY PHYSICIANS LLC

Provider Business Mailing Address
First Line	:	1910 HIGHWAY 35
Second Line	:
City	:	OAKHURST
State	:	NJ
Zip	:	07755-2715
Country	:	US
Telephone Number	:	732-531-4747
Fax Number	:	732-663-0044

Provider Business Practice Location Address
First Line	:	196 JACK MARTIN BLVD STE A-2
Second Line	:
City	:	BRICK
State	:	NJ
Zip	:	08724-7769
Country	:	US
Telephone Number	:	732-458-4045
Fax Number	:	732-458-4979

Authorized Official
Title or Position	:	CHIEF OPERATING OFFICER
Name	:	MELISSA ANN MONAGHAN
Credential	:	PA-C
Telephone Number	:	732-531-0100

Provider Enumeration Date	:	08/30/2021
Last Update Date	:	08/30/2021

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