Provider Demographics
NPI:1356986186
Name:MONYE, JOSEPH IFEANYI (PHD)
Entity type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:IFEANYI
Last Name:MONYE
Suffix:
Gender:M
Credentials:PHD
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Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:5708 BELLONA AVE
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21212-3509
Mailing Address - Country:US
Mailing Address - Phone:443-750-4967
Mailing Address - Fax:443-703-7550
Practice Address - Street 1:5708 BELLONA AVE
Practice Address - Street 2:2ND FLOOR
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21212-3509
Practice Address - Country:US
Practice Address - Phone:443-750-4967
Practice Address - Fax:443-703-7550
Is Sole Proprietor?:No
Enumeration Date:2019-11-15
Last Update Date:2019-11-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDBH001929364SP0810X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SP0810XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health, Child & Family