Provider Demographics
NPI:1265169759
Name:MONSEY MEDICAL, P.C.
Entity type:Organization
Organization Name:MONSEY MEDICAL, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGEMENT OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:SHRAGA
Authorized Official - Middle Name:
Authorized Official - Last Name:GOLD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:845-425-2299
Mailing Address - Street 1:20 ROBERT PITT DR STE 212
Mailing Address - Street 2:
Mailing Address - City:MONSEY
Mailing Address - State:NY
Mailing Address - Zip Code:10952-3340
Mailing Address - Country:US
Mailing Address - Phone:845-425-2299
Mailing Address - Fax:845-302-1687
Practice Address - Street 1:20 ROBERT PITT DR STE 212
Practice Address - Street 2:
Practice Address - City:MONSEY
Practice Address - State:NY
Practice Address - Zip Code:10952-3340
Practice Address - Country:US
Practice Address - Phone:845-425-2299
Practice Address - Fax:845-302-1687
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-04
Last Update Date:2022-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
No252Y00000XAgenciesEarly Intervention Provider Agency