Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2080P0204X | Pediatric Emergency Doctor | 25MA10569000 | NJ |
Y | 2080P0204X | Pediatric Emergency Doctor | MD467929 | PA |
NPI | 1093081184 |
---|---|
Provider Name | Miss Monica Maria Prieto |
First Address | Philadelphia, PA 19104-3820 |
Second Address | Philadelphia, PA 19104-4319 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/03/2012 |
Last Update Date | 19/03/2020 |