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General NPI Number Information
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NPI Number | 1912672510
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Entity Type | Organization
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Legal Business Name | MONMOUTH ENT ASSOCIATES, LLC
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Dates
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Enumeration Date | 08/16/2021
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Last Update Date | 04/10/2023
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Provider Practice Location Address
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Address Line | 180 AVENUE AT THE CMN STE 8A
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City | SHREWSBURY
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State | NJ
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Zip | 07702-4569
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Country | US
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Telephone | 732-868-8622
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Fax | 732-862-8687
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Provider Business Mailing Address
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Address Line | 180 AVENUE AT THE CMN STE 8A
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City | SHREWSBURY
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State | NJ
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Zip | 07702-4569
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Country | US
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Telephone | 732-868-8622
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Fax | 732-862-8687
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Authorized Official
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Title or Position | OWNER
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Name | EUN HAE CHANG
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Credential | MDCM, MPH, FRCSC
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Telephone | 732-370-5553
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number |
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License Number State |
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