Healthcare Provider Details

I. General information

NPI: 1013918101
Provider Name (Legal Business Name): MONIKA NEIL DAFTARY PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 08/10/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2041 GEORGIA AVE NW SUITE B ROOM 1-OP-64 (AMBULATORY CARE SUITE)
WASHINGTON DC
20060-0001
US

IV. Provider business mailing address

2300 4TH STREET, NW
WASHINGTON DC
20059-0001
US

V. Phone/Fax

Practice location:
  • Phone: 202-865-7802
  • Fax: 202-865-7803
Mailing address:
  • Phone: 202-806-4206
  • Fax: 202-806-4478

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPH3063
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: