| Doctor Name: | MARYANN MONGE |
| NPI Number: | 1124320403 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | RN |
| License Number: | 473427-1 |
| Business Practice Address: | 140 Wilkesbarre St Lackawanna, NY - 142181146 |
| Business Phone Number: | 7168220877 |
| Business Fax Number: | |
| Mailing Address: | 140 Wilkesbarre St, LACKAWANNA |
| State: | NY |
| Postal Code: | 142181146 |
| Phone Number: | 7168220877 |
| Fax Number: | |
| NPI Enumeration Date: | 11/19/2010 |
| NPI Last Update Date: | 11/19/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 163WH0200X |
| License Number: | 473427-1 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Nursing Service Providers |
| Taxonomy Classification: | Registered Nurse |
| Taxonomy Specialization: | Home Health |
| Taxonomy Definition: | |