Healthcare Provider Details

I. General information

NPI: 1033704515
Provider Name (Legal Business Name): MONIQUE BIALOGLOWICZ RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/05/2021
Last Update Date: 03/05/2021
Certification Date: 03/05/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

320 HIGH ST NE
WARREN OH
44481-1222
US

IV. Provider business mailing address

320 HIGH ST NE
WARREN OH
44481-1222
US

V. Phone/Fax

Practice location:
  • Phone: 330-393-9090
  • Fax:
Mailing address:
  • Phone: 330-393-9090
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License NumberRN.431615
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: