Eatontown Primary Care, LLC

Primary specialty

SpecialistTaxonomy code 174400000X

License

25MA07738500 Issued in NJ

Legal business name

EATONTOWN PRIMARY CARE, LLC

Practice address

117 State Route 35
Eatontown, NJ 07724-1885

Phone

(732) 542-4411

Fax

(732) 542-1070

NPI assigned

Sep 19, 2007

Last updated

Jan 25, 2011By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Manar H Hanna, MDNPI 1588625859

Title

MD

Phone

(732) 542-4411

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NJ2 enrollments

Enrollment records 2

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Manar Hanna, MD

  • Internal Medicine Physician
  • Eatontown, NJ
  • NPI 1588625859
  Medicare reassignment Care Compare group NPD Authorized official
• Marielle Recho, M.D.

  • Internal Medicine Physician
  • Eatontown, NJ
  • NPI 1275739799
  Medicare reassignment Care Compare group NPD
• David L Robbins Jr., MD

  • Cardiovascular Disease Physician
  • Pittsburg, KS
  • NPI 1871580738
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1190160000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1295913600000",
    "number": "1902092281",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "117 STATE ROUTE 35",
            "city": "EATONTOWN",
            "state": "NJ",
            "postal_code": "077241885"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "117 STATE ROUTE 35",
            "city": "EATONTOWN",
            "state": "NJ",
            "postal_code": "077241885",
            "telephone_number": "732-542-4411",
            "fax_number": "732-542-1070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EATONTOWN PRIMARY CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-19",
        "last_updated": "2011-01-25",
        "status": "A",
        "authorized_official_last_name": "HANNA",
        "authorized_official_first_name": "MANAR",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "MD",
        "authorized_official_telephone_number": "732-542-4411",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NJ",
            "license": "25MA07738500",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP NUMBER",
            "identifier": "099326",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Anne Dunigan, LCSW
• Dunphy Physical Therapy, Inc.
• Dora Isabel Duque, M.D.
• Shelby Dutkiewicz, LSW
• Eatontown Elite Care Center, LLC
• Eatontown Public Schools
• Amy Edelman, APN
• Shannon T Edgeworth, LCSW
• Barry J Edison, D.O.
• Alice Eduwu

• Specialist in Eatontown, NJ
• Providers in Eatontown, NJ by specialty
• Specialist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.