Provider Demographics
NPI:1760213284
Name:MONAT-DEJESUS, ALLEGRA
Entity type:Individual
Prefix:MRS
First Name:ALLEGRA
Middle Name:
Last Name:MONAT-DEJESUS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 DAVENPORT AVE APT 5H
Mailing Address - Street 2:
Mailing Address - City:NEW ROCHELLE
Mailing Address - State:NY
Mailing Address - Zip Code:10805-3456
Mailing Address - Country:US
Mailing Address - Phone:914-312-5085
Mailing Address - Fax:
Practice Address - Street 1:89 BARTLETT ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11206-4463
Practice Address - Country:US
Practice Address - Phone:718-384-2418
Practice Address - Fax:718-782-0263
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-08
Last Update Date:2024-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist