Provider Demographics
NPI:1265435101
Name:HJEMDAHL-MONSEN, CRAIG (MD)
Entity type:Individual
Prefix:DR
First Name:CRAIG
Middle Name:
Last Name:HJEMDAHL-MONSEN
Suffix:
Gender:M
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:PO BOX 5801
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10087-5801
Mailing Address - Country:US
Mailing Address - Phone:914-593-7800
Mailing Address - Fax:914-593-7881
Practice Address - Street 1:40 SAW MILL RIVER RD STE UL1
Practice Address - Street 2:
Practice Address - City:HAWTHORNE
Practice Address - State:NY
Practice Address - Zip Code:10532-1535
Practice Address - Country:US
Practice Address - Phone:914-593-7800
Practice Address - Fax:914-593-7881
Is Sole Proprietor?:No
Enumeration Date:2005-05-24
Last Update Date:2024-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY154816207RC0000X, 207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01042231Medicaid
NY060023509OtherRAIL ROAD MEDICARE
NY060023509OtherRAIL ROAD MEDICARE
NYA400061882Medicare PIN
NY01042231Medicaid
NY98D121Medicare ID - Type Unspecified