Provider Demographics
NPI:1427364553
Name:DR. MONA AWAD, MD
Entity Type:Organization
Organization Name:DR. MONA AWAD, MD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DOCTOR
Authorized Official - Prefix:
Authorized Official - First Name:MONA
Authorized Official - Middle Name:
Authorized Official - Last Name:AWAD
Authorized Official - Suffix:
Authorized Official - Credentials:M D
Authorized Official - Phone:732-264-5005
Mailing Address - Street 1:PO BOX 384
Mailing Address - Street 2:
Mailing Address - City:HOLMDEL
Mailing Address - State:NJ
Mailing Address - Zip Code:07733-0384
Mailing Address - Country:US
Mailing Address - Phone:732-264-5005
Mailing Address - Fax:732-264-1843
Practice Address - Street 1:1 BETHANY RD BLDG 6
Practice Address - Street 2:SUITE 85
Practice Address - City:HAZLET
Practice Address - State:NJ
Practice Address - Zip Code:07730-1669
Practice Address - Country:US
Practice Address - Phone:732-264-5005
Practice Address - Fax:732-264-1843
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MONA AWAD, MD
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-08-26
Last Update Date:2010-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA06301100207RP1001X, 332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Multi-Specialty
No332B00000XSuppliersDurable Medical Equipment & Medical SuppliesGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJG19670Medicare UPIN
NJ817161Medicare PIN