Healthcare Provider Details

I. General information

NPI: 1649807710
Provider Name (Legal Business Name): ERICA MONROSE MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/26/2020
Last Update Date: 12/12/2025
Certification Date: 12/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 GUSTAVE L LEVY PL
NEW YORK NY
10029-6504
US

IV. Provider business mailing address

271 W 144TH ST APT 6C
NEW YORK NY
10030-1294
US

V. Phone/Fax

Practice location:
  • Phone: 646-436-5225
  • Fax:
Mailing address:
  • Phone: 646-436-5225
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number332601
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: