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General NPI Number Information
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NPI Number | 1972634970
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Entity Type | Organization
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Legal Business Name | MONACO PSYCHOLOGICAL SERVICES
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Dates
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Enumeration Date | 03/08/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 817 BROADWAY 9TH FLOOR, SUITE 4
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City | NEW YORK
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State | NY
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Zip | 10003-4709
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Country | US
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Telephone | 646-388-2734
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Fax |
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Provider Business Mailing Address
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Address Line | 817 BROADWAY 9TH FLOOR, SUITE 4
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City | NEW YORK
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State | NY
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Zip | 10003-4709
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. LOUIS MONACO
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Credential | PSY.D.
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Telephone | 646-388-2734
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 016252
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License Number State | NY
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