Provider Demographics
NPI:1659538080
Name:EVERETT, MONICA A (OD)
Entity Type:Individual
Prefix:DR
First Name:MONICA
Middle Name:A
Last Name:EVERETT
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:811 CHESTNUT RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:CHESTNUT RIDGE
Mailing Address - State:NY
Mailing Address - Zip Code:10977-6330
Mailing Address - Country:US
Mailing Address - Phone:845-352-2020
Mailing Address - Fax:845-352-2097
Practice Address - Street 1:811 CHESTNUT RIDGE RD
Practice Address - Street 2:
Practice Address - City:CHESTNUT RIDGE
Practice Address - State:NY
Practice Address - Zip Code:10977-6330
Practice Address - Country:US
Practice Address - Phone:845-352-2020
Practice Address - Fax:845-352-2097
Is Sole Proprietor?:No
Enumeration Date:2008-05-22
Last Update Date:2008-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYVUT005859152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist