Provider Demographics
NPI:1497392617
Name:DR. JENNIFER MCMONIGLE MEDICAL, P.C.
Entity Type:Organization
Organization Name:DR. JENNIFER MCMONIGLE MEDICAL, P.C.
Other - Org Name:MCMONIGLE-NEUROLOGY ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:MCMONIGLE
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:631-230-6644
Mailing Address - Street 1:554 LARKFIELD RD STE 10G
Mailing Address - Street 2:
Mailing Address - City:EAST NORTHPORT
Mailing Address - State:NY
Mailing Address - Zip Code:11731-4205
Mailing Address - Country:US
Mailing Address - Phone:631-230-6644
Mailing Address - Fax:631-230-6645
Practice Address - Street 1:554 LARKFIELD RD STE 10G
Practice Address - Street 2:
Practice Address - City:EAST NORTHPORT
Practice Address - State:NY
Practice Address - Zip Code:11731-4205
Practice Address - Country:US
Practice Address - Phone:631-230-6644
Practice Address - Fax:631-230-6645
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-12-06
Last Update Date:2021-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty