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Individual

DR. ARMANDO J MONCADA JR.

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
85 HERRICK ST, BEVERLY, MA 01915-1790
(978) 922-3000
Mailing address
PROVIDER ENROLLMENT 41 MALL ROAD, BURLINGTON, MA 01805-0001

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
H9386
TX
174400000X
Specialist
MD07816R
LA
174400000X
Specialist
ME89563
FL
207ZP0101X
Anatomic Pathology Physician
Primary
53337
MA
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
053337
GA
291U00000X
Clinical Medical Laboratory
053337
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
053337
LICENSE
GA
05
383070886
GA
Enumeration date
11/29/2006
Last updated
06/25/2024
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