Healthcare Provider Details

I. General information

NPI: 1164625562
Provider Name (Legal Business Name): MONICA DILIP DALAL M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/06/2007
Last Update Date: 10/09/2023
Certification Date: 10/09/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2150 PENNSYLVANIA AVE NW
WASHINGTON DC
20037-3201
US

IV. Provider business mailing address

224-D CORNWALL ST. NW SUITE 403
LEESBURG VA
20176-2704
US

V. Phone/Fax

Practice location:
  • Phone: 202-741-2800
  • Fax: 202-741-2805
Mailing address:
  • Phone: 703-737-6010
  • Fax: 571-291-9786

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License NumberMD041384
License Number StateDC
# 2
Primary TaxonomyN
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number0101249757
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: