MEDICARE: DR. MONA AWAD, MD

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
1	332B00000X	Durable Medical Equipment & Medical Supplies	25MA06301100	NJ
2	207RP1001X	Pulmonary Disease Physician	25MA06301100	NJ

General Provider Information

NPI Number	:	1427364553
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DR. MONA AWAD, MD

Provider Business Mailing Address
First Line	:	PO BOX 384
Second Line	:
City	:	HOLMDEL
State	:	NJ
Zip	:	07733-0384
Country	:	US
Telephone Number	:	732-264-5005
Fax Number	:	732-264-1843

Provider Business Practice Location Address
First Line	:	1 BETHANY RD BLDG 6
Second Line	:	SUITE 85
City	:	HAZLET
State	:	NJ
Zip	:	07730-1669
Country	:	US
Telephone Number	:	732-264-5005
Fax Number	:	732-264-1843

Authorized Official
Title or Position	:	MEDICAL DOCTOR
Name	:	MONA AWAD
Credential	:	M. D.
Telephone Number	:	732-264-5005

Provider Enumeration Date	:	08/26/2010
Last Update Date	:	08/26/2010

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