1568652808 NPI number — MRS. CAROL MONACI PHD

Table of content: MRS. CAROL MONACI PHD (NPI 1568652808)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1568652808 NPI number — MRS. CAROL MONACI PHD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MONACI
Provider First Name:
CAROL
Provider Middle Name:
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
PHD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
FAHAD-LENZO
Provider Other First Name:
CAROL
Provider Other Middle Name:
Provider Other Name Prefix Text:
MS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1568652808
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/14/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
20 GIBSON PL STE 206
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
FREEHOLD
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
07728-4837
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
732-483-4425
Provider Business Mailing Address Fax Number:
732-483-4427

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
20 GIBSON PL STE 206
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FREEHOLD
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
07728-4837
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
732-483-4425
Provider Business Practice Location Address Fax Number:
732-483-4427
Provider Enumeration Date:
08/01/2007

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 103TC0700X , with the licence number:  37PC00021400 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 101YP2500X , with the licence number: 37PC00021400 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)