Healthcare Provider Details

I. General information

NPI: 1821139015
Provider Name (Legal Business Name): ENRIQUE H MONSANTO M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/09/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

263 7TH AVE
BROOKLYN NY
11215-3689
US

IV. Provider business mailing address

PO BOX 1610
PORT WASHINGTON NY
11050-0301
US

V. Phone/Fax

Practice location:
  • Phone: 718-771-1765
  • Fax:
Mailing address:
  • Phone: 718-771-1765
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207XS0106X
TaxonomyOrthopaedic Hand Surgery Physician
License Number141104-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: