Provider Demographics
NPI:1730654823
Name:MONEREAU, ESTHER BEATRICE
Entity Type:Individual
Prefix:
First Name:ESTHER
Middle Name:BEATRICE
Last Name:MONEREAU
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 1:61 BRADFORD ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11207-2501
Mailing Address - Country:US
Mailing Address - Phone:866-972-5877
Mailing Address - Fax:
Practice Address - Street 1:61 BRADFORD ST # 2
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11207-2501
Practice Address - Country:US
Practice Address - Phone:866-972-5877
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-04
Last Update Date:2018-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY1624029304713OtherNYC ID