Healthcare Provider Details

I. General information

NPI: 1033354030
Provider Name (Legal Business Name): ATLANTIC MEDICAL, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/05/2008
Last Update Date: 03/06/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1820 CORLIES AVE SUITE 7
NEPTUNE NJ
07753-4860
US

IV. Provider business mailing address

402 NEW CASTLE CT
MORGANVILLE NJ
07751-4256
US

V. Phone/Fax

Practice location:
  • Phone: 732-927-5541
  • Fax: 732-946-2674
Mailing address:
  • Phone: 908-670-0952
  • Fax: 732-946-2674

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number25MA079394
License Number StateNJ

VIII. Authorized Official

Name: DR. TONG K HAO
Title or Position: CEO
Credential: MD, PHD
Phone: 908-670-0952