Provider Demographics
NPI:1790091627
Name:THAPA, MONA (MD)
Entity Type:Individual
Prefix:
First Name:MONA
Middle Name:
Last Name:THAPA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9701 KEYSVILLE RD
Mailing Address - Street 2:
Mailing Address - City:EMMITSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:21727-8619
Mailing Address - Country:US
Mailing Address - Phone:301-447-2361
Mailing Address - Fax:
Practice Address - Street 1:9701 KEYSVILLE RD
Practice Address - Street 2:
Practice Address - City:EMMITSBURG
Practice Address - State:MD
Practice Address - Zip Code:21727-8619
Practice Address - Country:US
Practice Address - Phone:301-447-2360
Practice Address - Fax:203-781-4624
Is Sole Proprietor?:No
Enumeration Date:2010-08-30
Last Update Date:2024-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0531932084A0401X, 2084P0800X
MDD-830162084P0802X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0802XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyAddiction Psychiatry
No2084A0401XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyAddiction Medicine
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT004217099OtherMEDICAID PCS AT LONG WHARF
CTD400166547OtherMEDICARE THAPA
CT004082260OtherMEDICAID LEGION
CT008001325OtherMEDICAID LEGION
CT004041000OtherMEDICAID ACCESS CENTER
CT008053993OtherMEDICAID THAPA
CT008022622OtherMEDICAID LEGION