Provider Demographics
NPI:1700978855
Name:THROGS NECK MEDICAL SERVICES PC
Entity Type:Organization
Organization Name:THROGS NECK MEDICAL SERVICES PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:
Authorized Official - First Name:HABIB
Authorized Official - Middle Name:
Authorized Official - Last Name:MONAS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-828-5564
Mailing Address - Street 1:3795 E TREMONT AVE
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10465
Mailing Address - Country:US
Mailing Address - Phone:718-828-5564
Mailing Address - Fax:718-829-7984
Practice Address - Street 1:3795 E TREMONT AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10465
Practice Address - Country:US
Practice Address - Phone:718-828-5564
Practice Address - Fax:718-829-7984
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY190435207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01466357Medicaid
61I483Medicare ID - Type Unspecified
NY01466357Medicaid
W7Z491Medicare ID - Type Unspecified