Provider Demographics
NPI:1679655138
Name:SHORE ENT AND FACIAL PLASTICS, PA
Entity Type:Organization
Organization Name:SHORE ENT AND FACIAL PLASTICS, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ANOLI
Authorized Official - Middle Name:
Authorized Official - Last Name:MANIAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:732-961-8061
Mailing Address - Street 1:161 BARTLEY RD
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:NJ
Mailing Address - Zip Code:08527-1241
Mailing Address - Country:US
Mailing Address - Phone:732-961-8061
Mailing Address - Fax:732-886-2260
Practice Address - Street 1:161 BARTLEY RD
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:NJ
Practice Address - Zip Code:08527-1241
Practice Address - Country:US
Practice Address - Phone:732-961-8061
Practice Address - Fax:732-886-2260
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Single Specialty