Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207L00000X | Anesthesiologist | 238503 | NY |
Y | 207L00000X | Anesthesiologist | 25MA08393900 | NJ |
NPI | 1003007360 |
---|---|
Provider Name | Dr. Tina Deborah Montemurno |
First Address | Wyckoff, NJ 07481-1406 |
Second Address | Wyckoff, NJ 07481-1406 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/08/2007 |
Last Update Date | 17/08/2009 |