Healthcare Provider Details

I. General information

NPI: 1255969531
Provider Name (Legal Business Name): WESSLEY MONOLLESE DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/31/2020
Last Update Date: 06/04/2026
Certification Date: 06/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8 HUNTINGDON PIKE STE 100
ROCKLEDGE PA
19046-4351
US

IV. Provider business mailing address

3509 N BROAD ST
PHILADELPHIA PA
19140-4105
US

V. Phone/Fax

Practice location:
  • Phone: 215-663-8880
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberOS025231
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: