Basic Information
| Provider Information | |||||||||
| NPI: | 1144411281 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MONAGHAN | ||||||||
| FirstName: | ELICIA | ||||||||
| MiddleName: | ANNE | ||||||||
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| Credential: | CNM | ||||||||
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| Mailing Information | |||||||||
| Address1: | 151 LUQUER ST | ||||||||
| Address2: | APT 3 | ||||||||
| City: | BROOKLYN | ||||||||
| State: | NY | ||||||||
| PostalCode: | 112314011 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9177108103 | ||||||||
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| Practice Location | |||||||||
| Address1: | 760 BROADWAY | ||||||||
| Address2: | DEPT. OF OB/GYN - WOODHULL HOSPITAL | ||||||||
| City: | BROOKLYN | ||||||||
| State: | NY | ||||||||
| PostalCode: | 112065317 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7189638532 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 08/05/2007 | ||||||||
| LastUpdateDate: | 04/28/2009 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 367A00000X | F001283-1 | NY | Y | Physician Assistants & Advanced Practice Nursing Providers | Advanced Practice Midwife |
No ID Information.