Healthcare Provider Details

I. General information

NPI: 1962883207
Provider Name (Legal Business Name): MONIQUE S TERRY MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MONIQUE S HALL MD

II. Dates (important events)

Enumeration Date: 06/12/2015
Last Update Date: 06/23/2026
Certification Date: 06/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4050 N GEORGE STREET EXT
MANCHESTER PA
17345-9347
US

IV. Provider business mailing address

601 MEMORY LN
YORK PA
17402-2231
US

V. Phone/Fax

Practice location:
  • Phone: 717-356-4370
  • Fax: 717-260-3316
Mailing address:
  • Phone: 717-851-1405
  • Fax: 717-851-6969

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD462086
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: