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Individual

MONI SANUSI

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
10121 ANCIENT SEA PATH, LAUREL, MD 20723
(301) 325-7188
Mailing address
10121 ANCIENT SEA PATH, LAUREL, MD 20723-5862

Taxonomy

Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
23053
MD
174400000X
Specialist
23053
MD

Other

Enumeration date
12/23/2009
Last updated
12/23/2009
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