Healthcare Provider Details

I. General information

NPI: 1932675402
Provider Name (Legal Business Name): MONA KIRTIKUMAR SHETH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/22/2018
Last Update Date: 10/22/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

102 IRVING ST NW
WASHINGTON DC
20010-2921
US

IV. Provider business mailing address

17904 RED ROCKS DR
GERMANTOWN MD
20874-4428
US

V. Phone/Fax

Practice location:
  • Phone: 202-877-1760
  • Fax: 202-829-2789
Mailing address:
  • Phone: 202-329-8229
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: