Provider Demographics
NPI:1114391729
Name:COONEY-MONARD, GEORGETTE
Entity Type:Individual
Prefix:MRS
First Name:GEORGETTE
Middle Name:
Last Name:COONEY-MONARD
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 1:19 DALEWOOD CT
Mailing Address - Street 2:
Mailing Address - City:NEW CITY
Mailing Address - State:NY
Mailing Address - Zip Code:10956-4703
Mailing Address - Country:US
Mailing Address - Phone:845-638-6241
Mailing Address - Fax:
Practice Address - Street 1:19 DALEWOOD CT
Practice Address - Street 2:
Practice Address - City:NEW CITY
Practice Address - State:NY
Practice Address - Zip Code:10956-4703
Practice Address - Country:US
Practice Address - Phone:845-638-6241
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-11-19
Last Update Date:2015-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY30300339363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health