Provider Demographics
NPI:1417576166
Name:MONOPATIA, INC
Entity Type:Organization
Organization Name:MONOPATIA, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF ADMINISTRATIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:EDWIN
Authorized Official - Middle Name:
Authorized Official - Last Name:CHUKU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-618-6779
Mailing Address - Street 1:2719 PULASKI HWY STE 6
Mailing Address - Street 2:
Mailing Address - City:EDGEWOOD
Mailing Address - State:MD
Mailing Address - Zip Code:21040-1315
Mailing Address - Country:US
Mailing Address - Phone:410-618-6779
Mailing Address - Fax:
Practice Address - Street 1:2719 PULASKI HWY STE 6
Practice Address - Street 2:
Practice Address - City:EDGEWOOD
Practice Address - State:MD
Practice Address - Zip Code:21040-1315
Practice Address - Country:US
Practice Address - Phone:410-618-6779
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-13
Last Update Date:2023-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency