MEDICARE: DR. JENNEFER ERINNA MONCK M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084N0400X	Neurology Physician	MA07704600	NJ

General Provider Information

NPI Number	:	1720019516
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JENNEFER ERINNA MONCK M.D.

Provider Business Mailing Address
First Line	:	1680 ROUTE 23 STE 300
Second Line	:
City	:	WAYNE
State	:	NJ
Zip	:	07470-7520
Country	:	US
Telephone Number	:	973-942-4778
Fax Number	:	973-942-7020

Provider Business Practice Location Address
First Line	:	1680 ROUTE 23 STE 300
Second Line	:
City	:	WAYNE
State	:	NJ
Zip	:	07470-7520
Country	:	US
Telephone Number	:	973-942-4778
Fax Number	:	973-942-7020

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/06/2006
Last Update Date	:	01/29/2026

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