MEDICARE: DR. ROBERT MICHAEL MONAHAN D.C.

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	111N00000X	Chiropractor	MC03317	NJ

General Provider Information

NPI Number	:	1538188867
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ROBERT MICHAEL MONAHAN D.C.

Provider Business Mailing Address
First Line	:	1067 PALISADE AVE
Second Line	:
City	:	FORT LEE
State	:	NJ
Zip	:	07024-6329
Country	:	US
Telephone Number	:	201-886-8184
Fax Number	:	201-886-8483

Provider Business Practice Location Address
First Line	:	1067 PALISADE AVE
Second Line	:
City	:	FORT LEE
State	:	NJ
Zip	:	07024-6329
Country	:	US
Telephone Number	:	201-886-8184
Fax Number	:	201-886-8483

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/18/2006
Last Update Date	:	09/21/2009

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