Healthcare Provider Details

I. General information

NPI: 1720129729
Provider Name (Legal Business Name): JAMES EDWARD MONAHAN RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/11/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24 CHURCH ST
HOOSICK FALLS NY
12090-1600
US

IV. Provider business mailing address

20 BARTON AVE
HOOSICK FALLS NY
12090-2102
US

V. Phone/Fax

Practice location:
  • Phone: 518-686-5711
  • Fax: 518-686-1706
Mailing address:
  • Phone: 518-686-5983
  • Fax: 518-686-1706

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number030544-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: