Provider Demographics
NPI:1114696473
Name:MONROE, DORISKAY
Entity Type:Individual
Prefix:MS
First Name:DORISKAY
Middle Name:
Last Name:MONROE
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 1:156 STATE ROUTE 15
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:NJ
Mailing Address - Zip Code:07848-2607
Mailing Address - Country:US
Mailing Address - Phone:973-862-6377
Mailing Address - Fax:
Practice Address - Street 1:156 STATE ROUTE 15
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:NJ
Practice Address - Zip Code:07848-2607
Practice Address - Country:US
Practice Address - Phone:973-862-6377
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-09
Last Update Date:2021-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA00459200225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist