Provider Demographics
NPI:1356405419
Name:AWAD, MONA (MD)
Entity type:Individual
Prefix:DR
First Name:MONA
Middle Name:
Last Name:AWAD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 384
Mailing Address - Street 2:
Mailing Address - City:HOLMDEL
Mailing Address - State:NJ
Mailing Address - Zip Code:07733-0384
Mailing Address - Country:US
Mailing Address - Phone:732-264-5005
Mailing Address - Fax:732-264-1843
Practice Address - Street 1:1 BETHANY RD
Practice Address - Street 2:SUITE 85, BUILDING 6
Practice Address - City:HAZLET
Practice Address - State:NJ
Practice Address - Zip Code:07730-1663
Practice Address - Country:US
Practice Address - Phone:732-264-5005
Practice Address - Fax:732-264-1843
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJMA06301100207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJG19670Medicare UPIN