Provider Demographics
NPI:1689815961
Name:DAVID, MONICA DANA (MD)
Entity Type:Individual
Prefix:
First Name:MONICA
Middle Name:DANA
Last Name:DAVID
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:MONICA
Other - Middle Name:DANA
Other - Last Name:POP
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:55 WATER STREET
Mailing Address - Street 2:2ND FLOOR CRED DEPT
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10041-0004
Mailing Address - Country:US
Mailing Address - Phone:646-680-2888
Mailing Address - Fax:516-542-5556
Practice Address - Street 1:70 CHARLES LINDBERGH BLVD, STE. 100
Practice Address - Street 2:
Practice Address - City:UNIONDALE
Practice Address - State:NY
Practice Address - Zip Code:11553-3634
Practice Address - Country:US
Practice Address - Phone:516-483-2020
Practice Address - Fax:516-560-1855
Is Sole Proprietor?:No
Enumeration Date:2009-03-16
Last Update Date:2022-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY251707207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03078526Medicaid
NYA40003203Medicare PIN