Provider Demographics
NPI:1194766097
Name:DESOUSA, MONIKA ADAM (MPT)
Entity type:Individual
Prefix:MRS
First Name:MONIKA
Middle Name:ADAM
Last Name:DESOUSA
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:MONIKA
Other - Middle Name:JAYANTI
Other - Last Name:MUNJAPARA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MPT
Mailing Address - Street 1:2775 SCHOENERSVILLE RD
Mailing Address - Street 2:
Mailing Address - City:BETHLEHEM
Mailing Address - State:PA
Mailing Address - Zip Code:18017-7307
Mailing Address - Country:US
Mailing Address - Phone:610-861-8080
Mailing Address - Fax:610-807-0366
Practice Address - Street 1:2775 SCHOENERSVILLE RD
Practice Address - Street 2:
Practice Address - City:BETHLEHEM
Practice Address - State:PA
Practice Address - Zip Code:18017-7307
Practice Address - Country:US
Practice Address - Phone:610-861-8080
Practice Address - Fax:610-807-0366
Is Sole Proprietor?:No
Enumeration Date:2006-06-10
Last Update Date:2008-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT017566225100000X
NJ40QA01182500225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
0090212000OtherINDEPENDENCE BLUE CROSS
0090212000OtherAMERIHEALTH
180537OtherHIGHMARK BLUE SHIELD
2201264OtherUNITED HEALTHCARE
0122144OtherAETNA PPO
01344201OtherCAPITAL BLUE CROSS
821695OtherFIRST PRIORITY HEALTH
329121OtherHEALTHAMERICA/HEALTHASSUR
0090212000OtherKEYSTONE HEALTH EAST
01344201OtherKEYSTONE HEALTH CENTRAL
1808084OtherCIGNA HEALTHCARE
P864427OtherOXFORD HEALTH PLANS
0090212000OtherKEYSTONE HEALTH EAST