MEDICARE: MONALISA JEAN-BAPTISTE M.D.

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	174400000X	Specialist	193644	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1679509665
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MONALISA JEAN-BAPTISTE M.D.

Provider Business Mailing Address
First Line	:	1318 E 66TH ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11234-5619
Country	:	US
Telephone Number	:	718-241-6304
Fax Number	:

Provider Business Practice Location Address
First Line	:	5000 AVENUE K
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11234-2202
Country	:	US
Telephone Number	:	718-968-1515
Fax Number	:	718-209-2295

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

Provider Enumeration Date	:	06/23/2006
Last Update Date	:	07/08/2007

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