Provider Demographics
NPI:1790711497
Name:AGAR, MONICA T (MD)
Entity Type:Individual
Prefix:
First Name:MONICA
Middle Name:T
Last Name:AGAR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2000 CRAWFORD PL STE 200
Mailing Address - Street 2:
Mailing Address - City:MOUNT LAUREL
Mailing Address - State:NJ
Mailing Address - Zip Code:08054-3954
Mailing Address - Country:US
Mailing Address - Phone:856-355-0340
Mailing Address - Fax:856-355-0330
Practice Address - Street 1:101 BURRS RD STE A&B
Practice Address - Street 2:
Practice Address - City:WESTAMPTON
Practice Address - State:NJ
Practice Address - Zip Code:08060
Practice Address - Country:US
Practice Address - Phone:609-261-0240
Practice Address - Fax:856-291-8880
Is Sole Proprietor?:No
Enumeration Date:2006-06-24
Last Update Date:2020-10-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MA06567000207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ7970005Medicaid
NJ027230Medicare ID - Type Unspecified
NJ7970005Medicaid