MEDICARE: DR. HENRY JOHN MONETTI DO

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	207Q00000X	Family Medicine Physician	106605	NY

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	:	1932171535
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. HENRY JOHN MONETTI DO

Provider Business Mailing Address
First Line	:	2500 NESCONSET HWY
Second Line	:	BLDG 7D
City	:	STONY BROOK
State	:	NY
Zip	:	11790-2555
Country	:	US
Telephone Number	:	631-751-3322
Fax Number	:	631-751-3844

Provider Business Practice Location Address
First Line	:	2500 NESCONSET HWY
Second Line	:	BLDG 7D
City	:	STONY BROOK
State	:	NY
Zip	:	11790-2555
Country	:	US
Telephone Number	:	631-751-3322
Fax Number	:	631-751-3844

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

Provider Enumeration Date	:	02/07/2006
Last Update Date	:	01/11/2026

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