Healthcare Provider Details

I. General information

NPI: 1598326951
Provider Name (Legal Business Name): MONAZZA CHAUDHRY MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/26/2019
Last Update Date: 06/24/2025
Certification Date: 06/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 6TH AVE N
ST CLOUD MN
56303
US

IV. Provider business mailing address

1200 6TH AVE N
ST CLOUD MN
56303
US

V. Phone/Fax

Practice location:
  • Phone: 320-251-2700
  • Fax:
Mailing address:
  • Phone: 320-251-2700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License Number79230
License Number StateMN
# 2
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number79230
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: