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Individual
DR. JENNIFER M MONCADA
Active
Individual
DR. JENNIFER M MONCADA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1572-604T
LA
152W00000X
Optometrist
4634
MA
152W00000X
Optometrist
OPC 4360
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0000025360
RI BCBS
RI
05
—
0715484
—
MA
05
—
1887897
—
LA
01
—
AA96447
HARVARD PILGRIM
MA
Enumeration date
08/14/2007
Last updated
12/09/2019
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