EATONTOWN PRIMARY CARE, LLC (NPI# 1902092281) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1902092281 |
| Entity Type | Organization |
| Organization Name | EATONTOWN PRIMARY CARE, LLC |
| Practice Address |
117 State Route 35 Eatontown NJ 07724-1885 |
| Practice Telephone | 7325424411 |
| Practice Fax Number | 7325421070 |
| Enumeration Date | 2007-09-19 |
| Last Update Date | 2011-01-25 |
| Authorized Official Name | DR. MANAR H HANNA (MD) |
| Authorized Official Telephone | 7325424411 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | 25MA07738500 | NJ | Other Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NJ | MEDICARE GROUP NUMBER | 099326 | 01 |
| Street Address |
117 STATE ROUTE 35 |
| City | EATONTOWN |
| State | NJ |
| Zip Code | 07724-1885 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588625859 | Manar Hanna | Internal Medicine | 117 State Route 35, Eatontown, NJ 07724-1885 | 2006-03-28 |
| 1528442381 | Kathleen Kozlowski | Counselor | 117 State Route 35, Suite 2, Eatontown, NJ 07724-1885 | 2015-07-11 |
| 1649661612 | Maher Hanna | Dentist | 117 State Route 35, Eatontown, NJ 07724-1885 | 2015-02-12 |
| 1730598921 | Megan Simkovich | Dietitian, Registered | 117 State Route 35, Suite 2, Eatontown, NJ 07724-1885 | 2014-08-13 |
| 1144651274 | Radha Singh | Counselor | 117 State Route 35, Suite 2, Eatontown, NJ 07724-1885 | 2013-11-27 |
| 1275739799 | Marielle Recho | Internal Medicine | 117 State Route 35, Eatontown, NJ 07724-1885 | 2007-06-22 |
| 1235167842 | Jordan L Kovacs | Counselor | 117 State Route 35, Suite 2, Eatontown, NJ 07724-1885 | 2006-06-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437719788 | Zsanae Lewis | Driver | 1 Main St Unit 401, Eatontown, NJ 07724 | 2019-06-18 |
| 1417419169 | Refocus | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 613 Hope Road, Building 5 and 2, Eatontown, NJ 07724 | 2019-04-02 |
| 1215401575 | Angela Fordham-lewis | Day Training/Habilitation Specialist | 613 Hope Road, Building #2, Eatontown, NJ 07724 | 2019-01-18 |
| 1174094312 | Patti Kousoulis | Counselor | 10 Industrial Way East, Eatontown, NJ 07724 | 2018-12-16 |
| 1649745589 | Jersey Shore Dental Spa LLC | Dentist | 613 Hope Road Building 5, Eatontown, NJ 07724 | 2018-10-08 |
| 1487135448 | A2z Diagnostics LLC | Pathology | 6 Industrial Way W Ste F19, Eatontown, NJ 07724 | 2018-08-27 |
| 1942708268 | Elyce Jackson | Counselor | 10 Industrial Way, Eatontown, NJ 07724 | 2018-02-01 |
| 1477065894 | The Arc of Monmouth, Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 36 Country Club Road Apt. 249, Eatontown, NJ 07724 | 2017-10-25 |
| 1639681059 | The Arc of Monmouth, Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 36 Country Club Road Apt. 277, Eatontown, NJ 07724 | 2017-10-25 |
| 1669998100 | Seacrest Recovery Center North Jersey, LLC | Psychologist | 162 Highway 35, Eatontown, NJ 07724 | 2017-08-16 |
| Find all providers in zip 07724 | ||||
| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194109231 | Alice Sherrington Imhof | Specialist | 33 Corbett Way, New Leaf Florida LLC, Eatontown, NJ 07724 | 2015-07-18 |
| 1306150586 | Kristi White | Specialist | 41 Lake Ave, Eatontown, NJ 07724 | 2010-07-30 |
| 1699826420 | Michael George Ashkar | Specialist | 44 Monmouth Rd, Eatontown, NJ 07724-2343 | 2007-01-16 |
| 1902964364 | Womens Health Alliance LLC | Specialist | 142 Hwy 35, Ste 105, Eatontown, NJ 07724-3427 | 2006-12-05 |
| 1902994759 | Elaine Mccarron | Specialist | 1 Industrial Way W Bldg A, Eatontown, NJ 07724-2255 | 2006-10-10 |
| 1457346918 | Alfonso Ciervo | Specialist | 142 Highway 35, Suite 106a, Eatontown, NJ 07724-3427 | 2005-09-12 |
| 1477686186 | Shore Rehabilitation Services | Specialist | 1 Industrial Way W Bldg A, Eatontown, NJ 07724-2255 | 2007-03-13 |
| 1427128933 | Hudson Heart Group, PC | Specialist | 1265 Paterson Plank Road, Suite 106a, Eatontown, NJ 07724 | 2006-11-09 |
| 1083712541 | Monmouth Pulmonary Consultants P A | Specialist | 30 Corbett Way, Eatontown, NJ 07724-2263 | 2006-09-20 |
| 1477591006 | Innovative Vascular Group | Specialist | 142 Highway 35, Suite 106a, Eatontown, NJ 07724-3427 | 2006-06-04 |
| Find all providers in EATONTOWN | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.