Provider Demographics
NPI:1891730099
Name:NOWAK, MONICA SANDY (DC)
Entity Type:Individual
Prefix:DR
First Name:MONICA
Middle Name:SANDY
Last Name:NOWAK
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:MONICA
Other - Middle Name:SANDY
Other - Last Name:WARCHOL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:290 ROBERTS ST STE 202
Mailing Address - Street 2:
Mailing Address - City:EAST HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06108-3656
Mailing Address - Country:US
Mailing Address - Phone:860-290-3788
Mailing Address - Fax:860-290-3789
Practice Address - Street 1:290 ROBERTS ST STE 202
Practice Address - Street 2:
Practice Address - City:EAST HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06108
Practice Address - Country:US
Practice Address - Phone:860-290-3788
Practice Address - Fax:860-290-3789
Is Sole Proprietor?:No
Enumeration Date:2006-06-19
Last Update Date:2019-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00629800111N00000X
CT001818111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ096724Medicare ID - Type Unspecified