Healthcare Provider Details

I. General information

NPI: 1952831901
Provider Name (Legal Business Name): MONICA BEBAWY DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/13/2017
Last Update Date: 12/05/2023
Certification Date: 12/05/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

345 E 24TH ST
NEW YORK NY
10010-4020
US

IV. Provider business mailing address

305 E 24TH ST APT 9M
NEW YORK NY
10010-4025
US

V. Phone/Fax

Practice location:
  • Phone: 732-673-1992
  • Fax:
Mailing address:
  • Phone: 732-673-1992
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number060029
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: