Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RC0000X | Internist - Cardiovascular Disease | 25MA03358100 | NJ |
NPI | 1013025881 |
---|---|
Provider Name | Dr. Joseph W Montagnino |
First Address | Wyckoff, NJ 07481 |
Second Address | Hawthorne, NJ 07506 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/08/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
C56271 | (02) |