Provider Demographics
NPI:1265021950
Name:EL-SHERIF, MONA (NP)
Entity Type:Individual
Prefix:
First Name:MONA
Middle Name:
Last Name:EL-SHERIF
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:252 LIVINGSTON AVE # A
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10314-6932
Mailing Address - Country:US
Mailing Address - Phone:917-861-5263
Mailing Address - Fax:718-698-3056
Practice Address - Street 1:252 LIVINGSTON AVE # A
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10314-6932
Practice Address - Country:US
Practice Address - Phone:917-861-5263
Practice Address - Fax:718-698-3056
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-16
Last Update Date:2021-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF310107-01363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health