Provider Demographics
NPI:1598779787
Name:REED, MONICA R (MD)
Entity Type:Individual
Prefix:
First Name:MONICA
Middle Name:R
Last Name:REED
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 1:71 PROSPECT AVE
Mailing Address - Street 2:
Mailing Address - City:HUDSON
Mailing Address - State:NY
Mailing Address - Zip Code:12534-2927
Mailing Address - Country:US
Mailing Address - Phone:185-828-3327
Mailing Address - Fax:
Practice Address - Street 1:COLUMBIA MEMORIAL FAMILY CARE
Practice Address - Street 2:71 PROSPECT AVE, SUITE 110
Practice Address - City:HUDSON
Practice Address - State:NY
Practice Address - Zip Code:12534
Practice Address - Country:US
Practice Address - Phone:518-828-3327
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-27
Last Update Date:2023-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY263005207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CORE44881OtherBCBS
CO04181069Medicaid
CO04181069Medicaid
CO04181069Medicaid
COP00351110Medicare PIN