Provider Demographics
NPI:1467917120
Name:REID, MONIQUE NATASHA
Entity Type:Individual
Prefix:
First Name:MONIQUE
Middle Name:NATASHA
Last Name:REID
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 1:5605 KEY AVE APT 1
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21215-4054
Mailing Address - Country:US
Mailing Address - Phone:443-226-8806
Mailing Address - Fax:
Practice Address - Street 1:6600 YORK RD STE 207
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21212-2024
Practice Address - Country:US
Practice Address - Phone:410-864-8181
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-07
Last Update Date:2019-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomyGroup - Single Specialty