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General NPI Number Information
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NPI Number | 1922249069
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Entity Type | Individual
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Provider Name | KATHI MONROE L.AC.
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Gender | Female
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Dates
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Enumeration Date | 03/19/2009
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Last Update Date | 03/19/2009
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Provider Practice Location Address
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Address Line | 47 BOUNDARY AVE STE 8
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City | S FARMINGDALE
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State | NY
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Zip | 11735-4450
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Country | US
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Telephone | 516-790-8158
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Fax | 516-249-8213
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Provider Business Mailing Address
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Address Line | 47-8 BOUNDARY AVENUE
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City | S FARMINGDALE
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State | NY
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Zip | 11735
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Country | US
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Telephone | 516-790-8158
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Fax | 516-249-8213
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | 002501
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License Number State | NY
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