Provider Demographics
NPI:1083723654
Name:MONACO, DANA O (MD)
Entity Type:Individual
Prefix:DR
First Name:DANA
Middle Name:O
Last Name:MONACO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:2 SAINT CLAIR ST
Mailing Address - Street 2:
Mailing Address - City:LYNBROOK
Mailing Address - State:NY
Mailing Address - Zip Code:11563-1719
Mailing Address - Country:US
Mailing Address - Phone:516-766-8600
Mailing Address - Fax:516-766-8858
Practice Address - Street 1:2000 N VILLAGE AVE
Practice Address - Street 2:SUITE 209
Practice Address - City:ROCKVILLE CENTRE
Practice Address - State:NY
Practice Address - Zip Code:11570-1078
Practice Address - Country:US
Practice Address - Phone:516-766-8600
Practice Address - Fax:516-766-8858
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-29
Last Update Date:2008-03-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY163611-1208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYF71353Medicare UPIN
NY15I541Medicare ID - Type Unspecified