Healthcare Provider Details

I. General information

NPI: 1265169759
Provider Name (Legal Business Name): MONSEY MEDICAL, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/04/2022
Last Update Date: 08/04/2022
Certification Date: 08/04/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20 ROBERT PITT DR STE 212
MONSEY NY
10952-3340
US

IV. Provider business mailing address

20 ROBERT PITT DR STE 212
MONSEY NY
10952-3340
US

V. Phone/Fax

Practice location:
  • Phone: 845-425-2299
  • Fax: 845-302-1687
Mailing address:
  • Phone: 845-425-2299
  • Fax: 845-302-1687

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License Number
License Number State

VIII. Authorized Official

Name: SHRAGA GOLD
Title or Position: MANAGEMENT OFFICER
Credential:
Phone: 845-425-2299