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General NPI Number Information
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NPI Number | 1972999373
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Entity Type | Individual
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Provider Name | JESSE MONAHAN MSW
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Gender | Male
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Dates
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Enumeration Date | 04/13/2015
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Last Update Date | 04/13/2015
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Provider Practice Location Address
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Address Line | 75 SEMINARY HILL RD
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City | CARMEL
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State | NY
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Zip | 10512-1921
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Country | US
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Telephone | 800-989-2676
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Fax | 845-704-6178
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Provider Business Mailing Address
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Address Line | PO BOX 417147
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City | BOSTON
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State | MA
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Zip | 02241-7147
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Country | US
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Telephone | 518-952-8140
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Fax | 518-952-8287
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | 093956
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License Number State | NY
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