Provider Demographics
NPI:1447753017
Name:MONACO, TERI (RN)
Entity Type:Individual
Prefix:
First Name:TERI
Middle Name:
Last Name:MONACO
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:TERI
Other - Middle Name:
Other - Last Name:MARGOLIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1127 AVALON COURT DR
Mailing Address - Street 2:
Mailing Address - City:MELVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:11747-4287
Mailing Address - Country:US
Mailing Address - Phone:904-303-5864
Mailing Address - Fax:
Practice Address - Street 1:1127 AVALON COURT DR
Practice Address - Street 2:
Practice Address - City:MELVILLE
Practice Address - State:NY
Practice Address - Zip Code:11747-4287
Practice Address - Country:US
Practice Address - Phone:904-303-5864
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-09
Last Update Date:2018-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY455669-1163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse