Healthcare Provider Details

I. General information

NPI: 1417136672
Provider Name (Legal Business Name): ENT & FACIAL PLASTIC SURGICAL ASSOCIATES, LLP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/24/2007
Last Update Date: 12/07/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8 QUAKERBRIDGE PLAZA
HAMILTON TOWNSHIP NJ
08619
US

IV. Provider business mailing address

8 QUAKERBRIDGE PLAZA
HAMILTON TOWNSHIP NJ
08619
US

V. Phone/Fax

Practice location:
  • Phone: 609-890-7800
  • Fax: 609-890-6148
Mailing address:
  • Phone: 609-890-7800
  • Fax: 609-890-6148

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number
License Number StateNJ

VIII. Authorized Official

Name: CINDY DOAN
Title or Position: OFFICE MANAGER
Credential:
Phone: 609-890-7800