Provider Demographics
NPI:1235943168
Name:MONACO-MARTINO, LAURA (BCNC)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:
Last Name:MONACO-MARTINO
Suffix:
Gender:F
Credentials:BCNC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:630 SHARROTTS RD
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10309-1964
Mailing Address - Country:US
Mailing Address - Phone:732-705-1509
Mailing Address - Fax:
Practice Address - Street 1:630 SHARROTTS RD
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10309-1964
Practice Address - Country:US
Practice Address - Phone:732-705-1509
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-03
Last Update Date:2025-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133N00000XDietary & Nutritional Service ProvidersNutritionist
No133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, Education
No171400000XOther Service ProvidersHealth & Wellness Coach