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General NPI Number Information
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NPI Number | 1790998805
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Entity Type | Organization
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Legal Business Name | ATLANTIC ENT ASSOCIATES, P.A.
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Dates
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Enumeration Date | 05/07/2007
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Last Update Date | 01/19/2011
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Provider Practice Location Address
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Address Line | 2640 HIGHWAY 70 BUILDING 6B
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City | MANASQUAN
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State | NJ
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Zip | 08736-2609
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Country | US
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Telephone | 732-223-8686
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Fax | 732-223-6572
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Provider Business Mailing Address
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Address Line | 2640 HIGHWAY 70 BUILDING 6B
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City | MANASQUAN
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State | NJ
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Zip | 08736-2609
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Country | US
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Telephone | 732-223-8686
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Fax | 732-223-6572
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MRS. ROXANNE D HOFFMANN
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Credential |
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Telephone | 732-223-8686
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207YS0123X
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Taxonomy Name | Facial Plastic Surgery Physician
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License Number | MB55529
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License Number State | NJ
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