| Organization Name: | MONMOUTH MEDICAL CENTER FACULTY PRACTICE PLAN, INC. |
| NPI Number: | 1023064441 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | TANYA KENNEY (MMCFPP MANAGER) |
| Mailing Address: | 300 2nd Ave Long Branch |
| State: | NJ US |
| Postal Code: | 077406303 |
| Phone Number: | 7325710025 |
| Fax Number: | 7325710400 |
| NPI Enumeration Date: | 05/26/2006 |
| NPI Last Update Date: | 03/09/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 207RA0000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Internal Medicine |
| Taxonomy Specialization: | Adolescent Medicine |
| Taxonomy Definition: | An internist who specializes in adolescent medicine is a multi-disciplinary healthcare specialist trained in the unique physical, psychological and social characteristics of adolescents, their healthcare problems and needs. |