Organization
ESOPUS MEDICAL, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MONIKA R.A. MOMMSEN MD (PRESIDENT)
(845) 658-7763
Entity
Organization
Contact information
Practice address
105 WOODCREST DR, RIFTON, NY 12471-7200
(845) 658-7763
Mailing address
10 HELLBROOK LN, ULSTER PARK, NY 12487-5209
(845) 658-7763
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
52862
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02533053
—
NY
Enumeration date
02/24/2006
Last updated
10/10/2022
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