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Individual

DR. JOHN PATRICK MONGAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.O.

Contact information

Practice address
6 MEDICAL PARK DR, SUITE 200, MALTA, NY 12020-5051
(518) 289-2717
(518) 886-5247
Mailing address
PO BOX 1368, ALBANY, NY 12201-1368
(518) 289-2717
(518) 886-5247

Taxonomy

Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
248746
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
03157797
NY
05
30228958
NH
Enumeration date
08/23/2006
Last updated
11/06/2015
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