Provider Demographics
NPI:1144231515
Name:TADROS, MONICA (MD)
Entity Type:Individual
Prefix:
First Name:MONICA
Middle Name:
Last Name:TADROS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 GRAND AVE
Mailing Address - Street 2:SUITE #104
Mailing Address - City:ENGLEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07631-4398
Mailing Address - Country:US
Mailing Address - Phone:201-408-5430
Mailing Address - Fax:201-408-5437
Practice Address - Street 1:300 GRAND AVE
Practice Address - Street 2:SUITE #104
Practice Address - City:ENGLEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07631-4398
Practice Address - Country:US
Practice Address - Phone:201-408-5430
Practice Address - Fax:201-408-5437
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-11
Last Update Date:2013-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY236921-1174400000X
NJ25MA07910000174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist