Healthcare Provider Details

I. General information

NPI: 1831363365
Provider Name (Legal Business Name): DAS CENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/16/2008
Last Update Date: 04/16/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

302 TWIN OAKS DR SUITE B
LAKEWOOD NJ
08701-7155
US

IV. Provider business mailing address

302 TWIN OAKS DR SUITE B
LAKEWOOD NJ
08701-7155
US

V. Phone/Fax

Practice location:
  • Phone: 732-272-8509
  • Fax: 732-942-9605
Mailing address:
  • Phone: 732-272-8509
  • Fax: 732-942-9605

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QH0700X
TaxonomyHearing and Speech Clinic/Center
License Number1603
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code261QH0700X
TaxonomyHearing and Speech Clinic/Center
License Number41YA00066100
License Number StateNJ

VIII. Authorized Official

Name: MRS. CHANIE MONOKER
Title or Position: EDUCATIONAL AUDIOLOGIST / OWNER
Credential: MS, CCC-A, TOH, TDHH
Phone: 732-272-8509