Provider Demographics
NPI:1821323965
Name:MONAH, LAURAINE
Entity Type:Individual
Prefix:
First Name:LAURAINE
Middle Name:
Last Name:MONAH
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:PO BOX 629
Mailing Address - Street 2:
Mailing Address - City:WESTBURY
Mailing Address - State:NY
Mailing Address - Zip Code:11590-0088
Mailing Address - Country:US
Mailing Address - Phone:516-333-0696
Mailing Address - Fax:
Practice Address - Street 1:120 W JOHN ST
Practice Address - Street 2:
Practice Address - City:HICKSVILLE
Practice Address - State:NY
Practice Address - Zip Code:11801-1020
Practice Address - Country:US
Practice Address - Phone:516-333-0696
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-10-07
Last Update Date:2009-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY522338163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse