Healthcare Provider Details

I. General information

NPI: 1003100199
Provider Name (Legal Business Name): HANNAH MONOKER MS CCC-A, TEH, TDHH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/06/2011
Last Update Date: 06/06/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

302 TWIN OAKS DR
LAKEWOOD NJ
08701-7155
US

IV. Provider business mailing address

302 TWIN OAKS DR
LAKEWOOD NJ
08701-7155
US

V. Phone/Fax

Practice location:
  • Phone: 732-272-8509
  • Fax:
Mailing address:
  • Phone: 732-272-8509
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number594382
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License Number594369
License Number StateNJ
# 3
Primary TaxonomyN
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number41YA00066100
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: