Basic Information
| Provider Information | |||||||||
| NPI: | 1720037146 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | MONROE FAMILY PRACTICE ASSOCIATES | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1803 W MAIN ST | ||||||||
| Address2: | |||||||||
| City: | STROUDSBURG | ||||||||
| State: | PA | ||||||||
| PostalCode: | 183601027 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5704210170 | ||||||||
| FaxNumber: | 5704245167 | ||||||||
| Practice Location | |||||||||
| Address1: | 1803 W MAIN ST | ||||||||
| Address2: | |||||||||
| City: | STROUDSBURG | ||||||||
| State: | PA | ||||||||
| PostalCode: | 183601027 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5704210170 | ||||||||
| FaxNumber: | 5704245167 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/10/2006 | ||||||||
| LastUpdateDate: | 12/06/2013 | ||||||||
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| AuthorizedOfficialLastName: | BRINKER | ||||||||
| AuthorizedOfficialFirstName: | JOHN | ||||||||
| AuthorizedOfficialMiddleName: | W. | ||||||||
| AuthorizedOfficialTitleorPosition: | PARNTER/PHYSICIAN | ||||||||
| AuthorizedOfficialTelephone: | 5704210170 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | D.O. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.