Provider Demographics
NPI:1477667509
Name:MONKOWSKI, ALFRED MATTHEW (MD)
Entity Type:Individual
Prefix:
First Name:ALFRED
Middle Name:MATTHEW
Last Name:MONKOWSKI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:81 BIG OAK RD
Mailing Address - Street 2:SUITE 102
Mailing Address - City:MORRISVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:19067-7801
Mailing Address - Country:US
Mailing Address - Phone:215-428-4501
Mailing Address - Fax:215-428-4502
Practice Address - Street 1:81 BIG OAK RD
Practice Address - Street 2:SUITE 102
Practice Address - City:MORRISVILLE
Practice Address - State:PA
Practice Address - Zip Code:19067-7801
Practice Address - Country:US
Practice Address - Phone:215-428-4501
Practice Address - Fax:215-428-4502
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD19531-E207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAB34687Medicare UPIN
PA063806Medicare ID - Type Unspecified