Provider Demographics
NPI:1598120685
Name:MONROY, NICOLLE
Entity Type:Individual
Prefix:
First Name:NICOLLE
Middle Name:
Last Name:MONROY
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 1:10335 120TH ST
Mailing Address - Street 2:APT E7
Mailing Address - City:SOUTH RICHMOND HILL
Mailing Address - State:NY
Mailing Address - Zip Code:11419-2013
Mailing Address - Country:US
Mailing Address - Phone:347-975-1023
Mailing Address - Fax:
Practice Address - Street 1:3136 88TH ST
Practice Address - Street 2:
Practice Address - City:EAST ELMHURST
Practice Address - State:NY
Practice Address - Zip Code:11369-1415
Practice Address - Country:US
Practice Address - Phone:718-205-1919
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-12-16
Last Update Date:2015-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator