Monica Gamal Boulos, MD
Student in an Organized Health Care Education/Training Program in New York, NY. Individual provider (NPI-1).
NPI number1366079949
StatusActive
Last updated in NPPESJun 24, 2025
Details
- NPI
- 1366079949
- Entity type
- Individual (NPI-1)
- Name
- Monica Gamal Boulos
- Credential
- MD
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Mar 24, 2020
- Certification date
- Jun 24, 2025
- Last updated
- Jun 24, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 390200000X | Student in an Organized Health Care Education/Training Program | – | – | Yes |
| 2085R0202X | Radiology, Diagnostic Radiology | 335194-01 | NY |
Practice location
1 Gustave L Levy Pl # 1234New York, NY 10029-6504
Phone 212-241-6388
Mailing address
9 Wyndover Woods Ln Apt 2White Plains, NY 10603-3161
Phone 718-570-6405
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