1427091057 NPI number — DR. WILLIAM ARTHUR MONACO O.D., PH.D.

Table of content: J.BARTON STERLING M.D. (NPI 1053478180)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1427091057 NPI number — DR. WILLIAM ARTHUR MONACO O.D., PH.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MONACO
Provider First Name:
WILLIAM
Provider Middle Name:
ARTHUR
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
O.D., PH.D.
Provider Gender Code:
M

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:
1427091057
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/20/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
23 LYNAM LOOKOUT DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NEWARK
Provider Business Mailing Address State Name:
DE
Provider Business Mailing Address Postal Code:
19702-1128
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
302-598-3698
Provider Business Mailing Address Fax Number:
302-292-2209

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
23 LYNAM LOOKOUT DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NEWARK
Provider Business Practice Location Address State Name:
DE
Provider Business Practice Location Address Postal Code:
19702-1128
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
302-598-3698
Provider Business Practice Location Address Fax Number:
302-292-2209
Provider Enumeration Date:
06/13/2006

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: 152W00000X , with the licence number:  I3-0001253 , registered in the state of DE ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: P00029433 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( DE ) . This identifiers is of the category "OTHER".
  • Identifier: 1000023163 , issued by the state of ( DE ) . This identifiers is of the category "MEDICAID".




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