1013918101 NPI number — DR. MONIKA NEIL DAFTARY PHARMD

Table of content: DR. MONIKA NEIL DAFTARY PHARMD (NPI 1013918101)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1013918101 NPI number — DR. MONIKA NEIL DAFTARY PHARMD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
DAFTARY
Provider First Name:
MONIKA
Provider Middle Name:
NEIL
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
PHARMD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1013918101
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2300 4TH STREET, NW
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WASHINGTON
Provider Business Mailing Address State Name:
DC
Provider Business Mailing Address Postal Code:
20059-0001
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
202-806-4206
Provider Business Mailing Address Fax Number:
202-806-4478

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2041 GEORGIA AVE NW
Provider Second Line Business Practice Location Address:
SUITE B ROOM 1-OP-64 (AMBULATORY CARE SUITE)
Provider Business Practice Location Address City Name:
WASHINGTON
Provider Business Practice Location Address State Name:
DC
Provider Business Practice Location Address Postal Code:
20060-0001
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
202-865-7802
Provider Business Practice Location Address Fax Number:
202-865-7803
Provider Enumeration Date:
08/10/2005

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: 183500000X , with the licence number:  PH3063 , registered in the state of DC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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