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NPI Code Detail

MEDICARE: MICHAEL PATRICK MONACO

MEDICARE: MICHAEL PATRICK MONACO
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
11041C0700XClinical Social Worker107745MA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1P10297OTHERMABLUE CROSS/BLUE SHIELD

General Provider Information

NPI Number : 1629041330
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHAEL PATRICK MONACO
Provider Business Mailing Address
First Line : 75 MOUNT AUBURN ST
Second Line :
City : CAMBRIDGE
State : MA
Zip : 02138-4960
Country : US
Telephone Number : 617-495-2323
Fax Number : 617-495-2327
Provider Business Practice Location Address
First Line : 75 MOUNT AUBURN ST
Second Line :
City : CAMBRIDGE
State : MA
Zip : 02138-4960
Country : US
Telephone Number : 617-495-2323
Fax Number : 617-495-2327
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/12/2006
Last Update Date : 03/09/2015

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Directions to “ MICHAEL PATRICK MONACO ” Practice Location

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