Provider Demographics
NPI:1316902042
Name:PEK, MONIKA ROSEMARY (MD)
Entity type:Individual
Prefix:DR
First Name:MONIKA
Middle Name:ROSEMARY
Last Name:PEK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1014 SKI BLUFF TER
Mailing Address - Street 2:
Mailing Address - City:LAKE ARIEL
Mailing Address - State:PA
Mailing Address - Zip Code:18436-8123
Mailing Address - Country:US
Mailing Address - Phone:570-795-3950
Mailing Address - Fax:
Practice Address - Street 1:277 NORTHERN BLVD STE 314
Practice Address - Street 2:
Practice Address - City:GREAT NECK
Practice Address - State:NY
Practice Address - Zip Code:11021-4703
Practice Address - Country:US
Practice Address - Phone:516-829-6646
Practice Address - Fax:516-829-0859
Is Sole Proprietor?:No
Enumeration Date:2006-04-18
Last Update Date:2019-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD4287532080A0000X
NYMD237826208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAMDOtherPA MEDICAL LICENSE
NYMDOtherNY MEDICAL LICENSE