| Doctor Name: | MISS MONICA L WATERLOO |
| NPI Number: | 1932434115 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PA |
| License Number: | TMA052174 |
| Business Practice Address: | 14351 Kutztown Rd Fleetwood, PA - 195229273 |
| Business Phone Number: | 6109448800 |
| Business Fax Number: | 6109448213 |
| Mailing Address: | Po Box 4000, 2nd Floor ALLENTOWN |
| State: | PA |
| Postal Code: | 181054000 |
| Phone Number: | 4848840183 |
| Fax Number: | 4848840628 |
| NPI Enumeration Date: | 10/06/2009 |
| NPI Last Update Date: | 11/12/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AM0700X |
| License Number: | TMA052174 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | PA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Medical |
| Taxonomy Definition: | |