Provider Demographics
NPI:1568430494
Name:MONCHOLI, ROSA A (MD)
Entity Type:Individual
Prefix:
First Name:ROSA
Middle Name:A
Last Name:MONCHOLI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22 LEWIS BAY RD
Mailing Address - Street 2:PRIMARY CARE INTERNISTS
Mailing Address - City:HYANNIS
Mailing Address - State:MA
Mailing Address - Zip Code:02601
Mailing Address - Country:US
Mailing Address - Phone:508-862-5560
Mailing Address - Fax:508-771-9714
Practice Address - Street 1:22 LEWIS BAY RD
Practice Address - Street 2:PRIMARY CARE INTERNISTS
Practice Address - City:HYANNIS
Practice Address - State:MA
Practice Address - Zip Code:02601
Practice Address - Country:US
Practice Address - Phone:508-862-5560
Practice Address - Fax:508-771-9714
Is Sole Proprietor?:No
Enumeration Date:2006-03-08
Last Update Date:2008-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA71326207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA60921OtherHPHC
MAJ08482OtherBCBS
D25483Medicare UPIN
J08482Medicare ID - Type Unspecified