Provider Demographics
NPI:1679115570
Name:GOLUBOVIC, MONICA MARIA
Entity Type:Individual
Prefix:
First Name:MONICA
Middle Name:MARIA
Last Name:GOLUBOVIC
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 1:623 LARCHMONT ACRES APT D
Mailing Address - Street 2:
Mailing Address - City:LARCHMONT
Mailing Address - State:NY
Mailing Address - Zip Code:10538-7351
Mailing Address - Country:US
Mailing Address - Phone:347-423-8218
Mailing Address - Fax:
Practice Address - Street 1:101 THEALL RD
Practice Address - Street 2:
Practice Address - City:RYE
Practice Address - State:NY
Practice Address - Zip Code:10580-1406
Practice Address - Country:US
Practice Address - Phone:914-925-8274
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-11
Last Update Date:2019-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant