Provider Demographics
NPI:1609945351
Name:MONACO, GAIL W (PH D)
Entity type:Individual
Prefix:DR
First Name:GAIL
Middle Name:W
Last Name:MONACO
Suffix:
Gender:F
Credentials:PH D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50 E 10TH ST
Mailing Address - Street 2:APT.4A
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10003-6221
Mailing Address - Country:US
Mailing Address - Phone:212-477-6764
Mailing Address - Fax:212-807-1210
Practice Address - Street 1:28 E 10TH ST
Practice Address - Street 2:SUITE 1J
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10003-6201
Practice Address - Country:US
Practice Address - Phone:212-807-1210
Practice Address - Fax:212-807-1210
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR025026-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYR025026-1OtherLICENSE NUMBER
NYP771285OtherOXFORD PROVIDER NUMDER
NYN41621Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER