Provider Demographics
NPI:1639134570
Name:KAKATY-MONZO, JOANNE MICHELLE (DO)
Entity Type:Individual
Prefix:
First Name:JOANNE
Middle Name:MICHELLE
Last Name:KAKATY-MONZO
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2250 OLD SENTINEL TRL
Mailing Address - Street 2:
Mailing Address - City:MALVERN
Mailing Address - State:PA
Mailing Address - Zip Code:19355-7500
Mailing Address - Country:US
Mailing Address - Phone:610-420-1615
Mailing Address - Fax:610-642-1607
Practice Address - Street 1:39 RITTENHOUSE PL
Practice Address - Street 2:
Practice Address - City:ARDMORE
Practice Address - State:PA
Practice Address - Zip Code:19003-2209
Practice Address - Country:US
Practice Address - Phone:610-420-1615
Practice Address - Fax:610-642-1607
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-20
Last Update Date:2024-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS012324207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OS012324OtherMEDICAL LICENSE
3873485OtherAETNA
067549TGWOtherMEDICARE PIN
PA1583457OtherBLUE SHIELD
PA7631545OtherAETNA
0870850OtherCIGNA
2262292000OtherBCBS PA PERCHOICE
1583457OtherBCBS PA HIGHMARK
2262292000OtherBCBS PA KEYSTONEE AMERIHE
1583457OtherBCBS PA HIGHMARK
3873485OtherAETNA