Provider Demographics
NPI:1033354030
Name:ATLANTIC MEDICAL, LLC
Entity Type:Organization
Organization Name:ATLANTIC MEDICAL, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:TONG
Authorized Official - Middle Name:K
Authorized Official - Last Name:HAO
Authorized Official - Suffix:
Authorized Official - Credentials:MD, PHD
Authorized Official - Phone:908-670-0952
Mailing Address - Street 1:402 NEW CASTLE CT
Mailing Address - Street 2:
Mailing Address - City:MORGANVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:07751-4256
Mailing Address - Country:US
Mailing Address - Phone:908-670-0952
Mailing Address - Fax:732-946-2674
Practice Address - Street 1:1820 CORLIES AVE
Practice Address - Street 2:SUITE 7
Practice Address - City:NEPTUNE
Practice Address - State:NJ
Practice Address - Zip Code:07753-4860
Practice Address - Country:US
Practice Address - Phone:732-927-5541
Practice Address - Fax:732-946-2674
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-05
Last Update Date:2013-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA079394207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty