Provider Demographics
NPI:1770723926
Name:MAHABIR, MONICA NADIA (PTA)
Entity type:Individual
Prefix:MS
First Name:MONICA
Middle Name:NADIA
Last Name:MAHABIR
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:32 HAWK RD
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08648-1353
Mailing Address - Country:US
Mailing Address - Phone:609-356-0655
Mailing Address - Fax:
Practice Address - Street 1:32 HAWK RD
Practice Address - Street 2:
Practice Address - City:LAWRENCEVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08648-1353
Practice Address - Country:US
Practice Address - Phone:609-356-0655
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-03-01
Last Update Date:2009-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJM01605627555792172V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker