Provider Demographics
NPI:1588690747
Name:MONCHIK, GERALD J (MD)
Entity type:Individual
Prefix:
First Name:GERALD
Middle Name:J
Last Name:MONCHIK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1030 PRESIDENT AVE
Mailing Address - Street 2:SUITE 3002
Mailing Address - City:FALL RIVER
Mailing Address - State:MA
Mailing Address - Zip Code:02720-5923
Mailing Address - Country:US
Mailing Address - Phone:508-676-3411
Mailing Address - Fax:508-676-0932
Practice Address - Street 1:1030 PRESIDENT AVE
Practice Address - Street 2:SUITE 3002
Practice Address - City:FALL RIVER
Practice Address - State:MA
Practice Address - Zip Code:02720-5923
Practice Address - Country:US
Practice Address - Phone:508-676-3411
Practice Address - Fax:508-676-0932
Is Sole Proprietor?:No
Enumeration Date:2006-06-22
Last Update Date:2020-04-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MAMA37145208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
1701012OtherUHC
202000OtherBLUE CHIP
RIGM07816Medicaid
3427518OtherAETNA
MA2019914Medicaid
7111118003OtherCIGNA FOR REFERRALS
8157OtherHPHC
MA020013711OtherRAILROAD MEDICARE
037145OtherTUFTS
000000021261OtherBMC
000367OtherSWH
0027846OtherNHP
B20914702OtherCIGNA
MAK08288OtherBLUE CROSS BLUE SHIELD
1701012OtherUHC
3427518OtherAETNA