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Individual

MARK MONROE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
289 LOUIS AVE, FLORAL PARK, NY 11001-3524
(347) 554-3810
(347) 554-3810
Mailing address
289 LOUIS AVE, FLORAL PARK, NY 11001

Taxonomy

Speciality
Code
Description
License number
State
103TS0200X
School Psychologist
Primary
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
17440000X
SPECIALIST
NY
Enumeration date
07/27/2017
Last updated
07/27/2017
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