Provider Demographics
NPI:1912672510
Name:MONMOUTH ENT ASSOCIATES, LLC
Entity Type:Organization
Organization Name:MONMOUTH ENT ASSOCIATES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:EUN
Authorized Official - Middle Name:HAE
Authorized Official - Last Name:CHANG
Authorized Official - Suffix:
Authorized Official - Credentials:MDCM, MPH, FRCSC
Authorized Official - Phone:732-370-5553
Mailing Address - Street 1:180 AVENUE AT THE CMN STE 8A
Mailing Address - Street 2:
Mailing Address - City:SHREWSBURY
Mailing Address - State:NJ
Mailing Address - Zip Code:07702-4569
Mailing Address - Country:US
Mailing Address - Phone:732-868-8622
Mailing Address - Fax:732-862-8687
Practice Address - Street 1:180 AVENUE AT THE CMN STE 8A
Practice Address - Street 2:
Practice Address - City:SHREWSBURY
Practice Address - State:NJ
Practice Address - Zip Code:07702-4569
Practice Address - Country:US
Practice Address - Phone:732-868-8622
Practice Address - Fax:732-862-8687
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-16
Last Update Date:2023-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Single Specialty