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NPI Code Detail

MEDICARE: MONALISA GHOSE M.D.

MEDICARE:   MONALISA  GHOSE  M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine PhysicianMD484522PA
2207Q00000XFamily Medicine Physician296600NY

General Provider Information

NPI Number : 1093178717
Entity Type Code : Individual
Provider Name (Legal Business Name) : MONALISA GHOSE M.D.
Provider Business Mailing Address
First Line : PO BOX 746722
Second Line :
City : ATLANTA
State : GA
Zip : 30374-6722
Country : US
Telephone Number : 312-733-9730
Fax Number :
Provider Business Practice Location Address
First Line : 1894 WALTON AVE
Second Line :
City : BRONX
State : NY
Zip : 10453-6018
Country : US
Telephone Number : 718-583-3060
Fax Number : 718-583-3360
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/30/2016
Last Update Date : 01/30/2026

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Directions to “ MONALISA GHOSE M.D.” Practice Location

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