Provider Demographics
NPI:1689338956
Name:LARGO, MONICA JOANNA (PHARMD)
Entity Type:Individual
Prefix:
First Name:MONICA
Middle Name:JOANNA
Last Name:LARGO
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:97 GREENWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:PEQUANNOCK
Mailing Address - State:NJ
Mailing Address - Zip Code:07440-1301
Mailing Address - Country:US
Mailing Address - Phone:973-975-2147
Mailing Address - Fax:
Practice Address - Street 1:1483 STATE RT 23
Practice Address - Street 2:
Practice Address - City:KINNELON
Practice Address - State:NJ
Practice Address - Zip Code:07405-1627
Practice Address - Country:US
Practice Address - Phone:973-838-4444
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-23
Last Update Date:2021-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI04212900183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist