Provider Demographics
NPI:1902862246
Name:MONAHAN, FRANCINE M (MD)
Entity Type:Individual
Prefix:
First Name:FRANCINE
Middle Name:M
Last Name:MONAHAN
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 1:165 DARTMOUTH STREET
Mailing Address - Street 2:INTERNAL MEDICINE
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02116
Mailing Address - Country:US
Mailing Address - Phone:617-859-5000
Mailing Address - Fax:
Practice Address - Street 1:165 DARTMOUTH STREET
Practice Address - Street 2:INTERNAL MEDICINE
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02116
Practice Address - Country:US
Practice Address - Phone:617-859-5000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-04-25
Last Update Date:2020-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA151072207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA3168352Medicaid
MAA22796Medicare PIN
MA3168352Medicaid