Healthcare Provider Details

I. General information

NPI: 1750846085
Provider Name (Legal Business Name): DR. MONICA REZK
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/31/2019
Last Update Date: 01/31/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

556 ATLANTIC AVE
BROOKLYN NY
11217-2275
US

IV. Provider business mailing address

110 GLENWOOD AVE APT 205
JERSEY CITY NJ
07306-5917
US

V. Phone/Fax

Practice location:
  • Phone: 347-889-6055
  • Fax:
Mailing address:
  • Phone: 201-993-4961
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number064994
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: