Provider Demographics
NPI:1073197505
Name:MONKA, NEAL (DO)
Entity type:Individual
Prefix:
First Name:NEAL
Middle Name:
Last Name:MONKA
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 EXECUTIVE DR APT 617
Mailing Address - Street 2:
Mailing Address - City:WEST ORANGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07052-3482
Mailing Address - Country:US
Mailing Address - Phone:973-975-6356
Mailing Address - Fax:
Practice Address - Street 1:456 PROSPECT AVE
Practice Address - Street 2:
Practice Address - City:WEST ORANGE
Practice Address - State:NJ
Practice Address - Zip Code:07052-4112
Practice Address - Country:US
Practice Address - Phone:973-731-6767
Practice Address - Fax:973-731-9881
Is Sole Proprietor?:No
Enumeration Date:2021-05-11
Last Update Date:2024-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
NJ25MA12233700207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program