MEDICARE: DR. MONIQUE J. TREMAINE PHD, MSCP

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
1	103TC0700X	Clinical Psychologist	35SI00438500	NJ
2	103G00000X	Clinical Neuropsychologist	051-A243	NJ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1235127218
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MONIQUE J. TREMAINE PHD, MSCP

Provider Business Mailing Address
First Line	:	23 GRAND AVE
Second Line	:
City	:	ATLANTIC HIGHLANDS
State	:	NJ
Zip	:	07716-1347
Country	:	US
Telephone Number	:	858-204-1717
Fax Number	:	973-799-9283

Provider Business Practice Location Address
First Line	:	23 GRAND AVE
Second Line	:
City	:	ATLANTIC HIGHLANDS
State	:	NJ
Zip	:	07716-1347
Country	:	US
Telephone Number	:	858-204-1717
Fax Number	:	973-799-9283

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/12/2005
Last Update Date	:	07/24/2023

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