Provider Demographics
NPI:1699702902
Name:HO, MONIQUE (MD)
Entity type:Individual
Prefix:
First Name:MONIQUE
Middle Name:
Last Name:HO
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 1:601 ELMWOOD AVE BOX 668
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14642-0001
Mailing Address - Country:US
Mailing Address - Phone:585-275-6393
Mailing Address - Fax:
Practice Address - Street 1:125 LATTIMORE RD STE 150
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14620-4156
Practice Address - Country:US
Practice Address - Phone:352-273-7584
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-26
Last Update Date:2023-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY239920207SG0201X, 207V00000X, 207VM0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VM0101XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyMaternal & Fetal Medicine
No207SG0201XAllopathic & Osteopathic PhysiciansMedical GeneticsClinical Genetics (M.D.)
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02753359Medicaid
NY02753359Medicaid
NYP020239920OtherBLUE SHIELD ROCHESTER
NY187480CKOtherPREFERRED CARE
FLHN834ZMedicare PIN
NY02753359Medicaid
NYJ400042936Medicare PIN