Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208100000X | Physical Medicine & Rehabilitation Doctor | 02005347A | IN |
Y | 208100000X | Physical Medicine & Rehabilitation Doctor | 25MB10420400 | NJ |
N | 208100000X | Physical Medicine & Rehabilitation Doctor | 296383-1 | NY |
NPI | 1033503255 |
---|---|
Provider Name | Nathaniel Montag |
First Address | Indianapolis, IN 46202-2207 |
Second Address | Englewood, NJ 07631-4967 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/03/2015 |
Last Update Date | 30/04/2019 |