Provider Demographics
NPI:1073859500
Name:MONK, MATTHEW R (CRNA)
Entity Type:Individual
Prefix:
First Name:MATTHEW
Middle Name:R
Last Name:MONK
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:24 S 18TH ST
Mailing Address - Street 2:
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18104-5622
Mailing Address - Country:US
Mailing Address - Phone:610-628-8372
Mailing Address - Fax:610-628-8648
Practice Address - Street 1:111 S 11TH ST
Practice Address - Street 2:SUITE 8490
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19107-4824
Practice Address - Country:US
Practice Address - Phone:215-955-6161
Practice Address - Fax:215-923-5507
Is Sole Proprietor?:No
Enumeration Date:2013-01-03
Last Update Date:2021-08-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PARN586901367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered