Provider Demographics
NPI:1730169939
Name:NORRIS, MONICA L (MD)
Entity type:Individual
Prefix:
First Name:MONICA
Middle Name:L
Last Name:NORRIS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 159
Mailing Address - Street 2:
Mailing Address - City:BARRINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08007-0159
Mailing Address - Country:US
Mailing Address - Phone:888-982-8594
Mailing Address - Fax:888-920-1525
Practice Address - Street 1:410 N KROCKS RD
Practice Address - Street 2:
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18106-9283
Practice Address - Country:US
Practice Address - Phone:888-982-8594
Practice Address - Fax:888-920-1525
Is Sole Proprietor?:No
Enumeration Date:2006-01-23
Last Update Date:2024-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD071967L207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA001888008Medicaid
PAH33077Medicare UPIN
PA046348Medicare ID - Type Unspecified