Provider Demographics
NPI:1205284932
Name:MONACO, DANIELLE MARIE (LAC)
Entity type:Individual
Prefix:MS
First Name:DANIELLE
Middle Name:MARIE
Last Name:MONACO
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1427 PACIFIC ST
Mailing Address - Street 2:APARTMENT 1
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11216-3595
Mailing Address - Country:US
Mailing Address - Phone:203-892-2073
Mailing Address - Fax:
Practice Address - Street 1:1427 PACIFIC ST
Practice Address - Street 2:APARTMENT 1
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11216-3595
Practice Address - Country:US
Practice Address - Phone:203-892-2073
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-03
Last Update Date:2016-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY5604-1171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist