Provider Demographics
NPI:1093968091
Name:SARJEANT, MONICA
Entity Type:Individual
Prefix:
First Name:MONICA
Middle Name:
Last Name:SARJEANT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:170 DREISER LOOP
Mailing Address - Street 2:APT 9 H
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10475-1902
Mailing Address - Country:US
Mailing Address - Phone:718-671-2100
Mailing Address - Fax:
Practice Address - Street 1:170 DREISER LOOP
Practice Address - Street 2:APT 9 H
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10475-1902
Practice Address - Country:US
Practice Address - Phone:718-671-2100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-11-04
Last Update Date:2010-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY280177164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse