Provider Demographics
NPI:1316007941
Name:KAUL, MONICA
Entity Type:Individual
Prefix:
First Name:MONICA
Middle Name:
Last Name:KAUL
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 1:33 WALT WHITMAN RD
Mailing Address - Street 2:STE 117
Mailing Address - City:HUNTINGTON STATION
Mailing Address - State:NY
Mailing Address - Zip Code:11746-3678
Mailing Address - Country:US
Mailing Address - Phone:631-425-2121
Mailing Address - Fax:
Practice Address - Street 1:33 WALT WHITMAN ROAD
Practice Address - Street 2:SUITE 235
Practice Address - City:HUNTINGTON STATION
Practice Address - State:NY
Practice Address - Zip Code:11746
Practice Address - Country:US
Practice Address - Phone:631-549-1480
Practice Address - Fax:631-549-2511
Is Sole Proprietor?:No
Enumeration Date:2006-12-12
Last Update Date:2017-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY230020207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02299470Medicaid
NY02299470Medicaid