Provider Demographics
NPI:1477541373
Name:MONFERRE, ADRIANA (MD)
Entity Type:Individual
Prefix:DR
First Name:ADRIANA
Middle Name:
Last Name:MONFERRE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:559 W GERMANTOWN PIKE
Mailing Address - Street 2:
Mailing Address - City:EAST NORRITON
Mailing Address - State:PA
Mailing Address - Zip Code:19403-4250
Mailing Address - Country:US
Mailing Address - Phone:484-622-4245
Mailing Address - Fax:484-622-2287
Practice Address - Street 1:100 E LANCASTER AVE
Practice Address - Street 2:SUITE B11
Practice Address - City:WYNNEWOOD
Practice Address - State:PA
Practice Address - Zip Code:19096-3450
Practice Address - Country:US
Practice Address - Phone:484-476-2658
Practice Address - Fax:484-476-3577
Is Sole Proprietor?:No
Enumeration Date:2005-10-13
Last Update Date:2020-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD062002L207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
G55495Medicare UPIN
PA959081N2PMedicare PIN
PA0016543300009Medicaid