MEDICARE: CARLINE MONTOUT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	171M00000X	Case Manager/Care Coordinator

General Provider Information

NPI Number	:	1841916079
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CARLINE MONTOUT

Provider Business Mailing Address
First Line	:	22018 HORACE HARDING EXPY
Second Line	:
City	:	BAYSIDE
State	:	NY
Zip	:	11364-2227
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	22018 HORACE HARDING EXPY
Second Line	:
City	:	OAKLAND GARDENS
State	:	NY
Zip	:	11364-2227
Country	:	US
Telephone Number	:	718-423-0056
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/19/2022
Last Update Date	:	10/19/2022

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Directions to “ CARLINE MONTOUT ” Practice Location

Language	Start Address	Practice Location

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