Provider Demographics
NPI:1730288606
Name:MONOPOLI, DOMINIC ANTHONY
Entity Type:Individual
Prefix:MR
First Name:DOMINIC
Middle Name:ANTHONY
Last Name:MONOPOLI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8243 153 AVE
Mailing Address - Street 2:
Mailing Address - City:BEACH
Mailing Address - State:NY
Mailing Address - Zip Code:11414
Mailing Address - Country:US
Mailing Address - Phone:718-848-7778
Mailing Address - Fax:
Practice Address - Street 1:8243 153RD AVE
Practice Address - Street 2:LINDEN PARK PHARMACY
Practice Address - City:HOWARD BEACH
Practice Address - State:NY
Practice Address - Zip Code:11414-1751
Practice Address - Country:US
Practice Address - Phone:718-848-7778
Practice Address - Fax:718-848-7447
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-21
Last Update Date:2011-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY41096183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist