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NPI Code Detail

MEDICARE: MARIE MONYOU GARGARD

MEDICARE: MARIE MONYOU GARGARD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1104100000XSocial Worker
2171M00000XCase Manager/Care Coordinator

General Provider Information

NPI Number : 1073816302
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARIE MONYOU GARGARD
Provider Business Mailing Address
First Line : 1216 ARCH ST FL 6
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19107-2835
Country : US
Telephone Number : 215-981-0088
Fax Number : 215-864-6931
Provider Business Practice Location Address
First Line : 1026 ARCH ST
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19107-3002
Country : US
Telephone Number : 267-940-5500
Fax Number : 215-207-0640
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/08/2010
Last Update Date : 12/08/2010

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Directions to “ MARIE MONYOU GARGARD ” Practice Location

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